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S.J.P�ieM{M]-167:55/ 3 /G . . I ." , �L� J' �, <br /> w.: rorm) <br /> CITY OF EVERETT--Water Dept. <br /> Application No....�1..:?l...�0.. Datey.I../.......................................:�.19..`.7 <br /> Install...........:.:.!I:........inch water aerrce pipe <br /> ;'� , _�. . <:- �,, 1:--:�'.:........................................ <br /> For .......................... .........:.....:J._------.... <br /> - . � , :. . ' � .._............... Street <br /> .: <br /> On ......................�.. ......:::_..........:....:..:..:...................... <br /> � �.� � <br /> :.ot.................:..:__..:.-............................ B1ock No..................................... <br /> Addition .................. ...............................t...................................................... <br /> . . <br /> � , -, <br /> Remarks .................:.....'.',i.......:.::......f...:.:...:..._:...:..._..�.....__......... <br /> ..... ................................................................................................................ <br /> ........................................................................................................................... <br /> .............. ..........._... ........--._ e..A:��....................... ............,......-...--- <br /> � <br /> ........... ...•.�..� ......1..::�................ ................._:............:::.:.:._:. <br /> ��t •�!�;;'J $uperintendent � <br /> � ' <br /> � � ` D MATERIAL DSED ' <br /> No. $izA ` ------ <br /> ---- . --. — <br /> ........................_..,....._`...."`� Lead Connection Complete <br /> .............................................._...... Snddl:CamPlete <br /> .......................ft....................._..... ............................---.........................................PiPe <br /> ................................................... <br /> ... Scrvice Cock <br /> .......................... Scrvice Sox <br /> ........................... . <br /> .................................................... .............................................................................................................. <br /> No. k:ours Labor................_...---.....................Cost................................................... <br /> Cutin....................Pavement....................X........................ ........................Sq.Ft. <br /> ...................X........................ �� <br /> ........................ <br /> ....................X..........----._....... ,� <br /> ........................ <br /> ....................X........................ ........................ �� <br /> Tutal ........................Sq.Ft. <br /> _ --_. ___. . <br /> Remarks....:..........._.......................................................................................,.... <br /> ��- .....................�........ .......................:...�::..1..�. <br /> ......_.._..............._.__..............._.. .. . , . <br /> t , . ' i <br /> ........................................................... ...... ........................................................ , <br /> OrderPeceived-- ......._......_......................... ............_.............................._ <br /> ��-ork Completed../..�.,..........�......,�.:.....:....................._..........................._./ <br /> Foreman <br />