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W. D fONM <br />PRICBC . 353 f <br />WO. <br />CITY OF EVERETT--Water Dept. <br />JUN1 1961 <br />Application No ........................ Date ................................................ 19...... <br />Install ............... ............. .inch water service pipe <br />For......................................a............................................................ _............... <br />On ...`/�9 7.!y�.. .....LIL4,✓.....K14... :............. __....... Street <br />Lot.............................................................. Block No ............ _..................... <br />Addition......................................................................................................... <br />Remarks....................... ............................... ....... 4................... _................ <br />Superintendent <br />LABOR AND MATERIAL USED <br />............. .... ....... ...........................I Lead Connection Complete <br />............... ..........._................__..... Saddle Complete <br />.......................1'.k ........................... ........ice*........_.........._......_...........................Pipe <br />......................................I......._..... Service Cock <br />Service Box - <br />................................................................................................. ........................ <br />.............................. .... ............. .................................................................... <br />OrderReceived .................. ....... ............................ .............................. <br />Work Completed ............. <br />Foreman <br />