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5 �.P���.M���3S 2 � . <br />w. o. tom. � <br />CITY OF EVERETT--Water Dept. <br />• ' rr ^ ( �-r,�_ i ................19_Y,'� <br />Applicalion No ��•?.Y..fDate....,.:� .................... <br />Install ......................:� :......inch watzr service pipe <br />.... <br />or...............................Q.....: ............................................ ..:.................... .. . <br />Ou ................. <br />.l. �.4..F........_a.� �l.r.... ��o- t:��� t.y: �c:�£treet <br />� <br />Lot......... .(.....� ........../. ... �....................._... Block o..................................._. <br />Addition ..........._.1...�?.1.�:�..:.`�.s.-......... ..C.h.c'�2:.5':�-.............. <br />Remarks <br />Ct vv��_ <br />..................................... ....... <br />�_ Superintendent <br />� LABOR AND MATLRiAL U9ED <br />No. I Sizc -- <br />L. <br />`f...i.�. <br />•, . .. <br />.......................... Lead Connection Complete <br />................._ . Sac�dlc omplete �(„_a.,.� . <br />�.—{� <br />.......�/w..�...��i ;,;/n_:.:�!' ..................._..........._!.....1..........Pipe <br />...... .... <br />..__�� ... Saivi�eCock <br />� �k�_ 9�c'r�nce Eoyxv �. f` fi <br />.� , �. _ r ........................ <br />ra Foo,� ....... <br />�� . ! r . -�.- n9.�ii�v�,�.. � G� � ,�� - -. � f ............._ <br />!v �✓� G .:� :Z! ,a � '� e . ,.!..L...� ......................... <br />�'PP � � <br />-. - .. . .. .. ..... .. �- <br />No. Hours 7.::oe:�_ ........................... <br />i •� _i i R :,;, - _ <br />Cut ir_ .....__ ....Pavement.......... <br />i.......... <br />, �A. <br />......................59. F:. <br />. .� <br />.7�1� "� � 5 _..........._....x ..............._.._... ....................... <br />.i ��� Total ......_ ............. Sq.Ft. <br />____ <br />_ _._ __ — __. <br />Remar 5..........._ ............................ <br />.................................................................... <br />Crder Recei�•ed ..........:...._........ <br />i^, ork Cnmpleled_ ..... ...._ _.. <br />.. ...............,.................... <br />........... ...._�................ <br />� <br />.......... _ .............1.............. <br />Foreman <br />