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5.�].PriebelM7-�14 ��' 3 <br />W. D. Form ] <br />CITY OF <br />EVERETT--Water Dept. <br />, =. 'J ' ' , '. <br />., - <br />Application No.'_.�.:�........... Date ........:::..:.:..::.—�.....[._...._.......1...:.:.: <br />Install ................................inch wat^r service pipc <br />� •--• <br />ror ................................................./.......j.............�_............................. .... <br />On ..._..........��.-.�. .�..�...7.........L�!.c?.:.:^..':��:'!.�!:�.?.L_r...-. Street <br />r ............... Bloc:t_No..----.................- - <br />Lot.._ ................ �-�....,-.............. , . <br />.. ......... <br />. . 4't,r . ,_ <br />Addition......._.(_._.:i..�t�..C.:.�t_� :...:...........:...... .................._............... <br />Remarks <br />....... - - - <br />� -�"' .............._... <br />..... . ..... :.....r` J.............. <br />_...-- ................................................ i <br />�/- ?✓ / � ?..�::'. .::: � ....................... <br />.... ...................... . <br />.. <br />..........................................._........ �;i�� SuPerintendent <br />�.�. <br />..... ..( .......... <br />� . <br />LAAOR ATtiD MATERIAL IISED <br />—i -- — <br />......I Lcad Connection Complete <br />..._ Saddle Complete <br />...... ..._.....�. <^ ..��..:�..i.::% ........................_ _.....Pipe <br />Sc�vi c Cd�ck� <br />, s�g� ��F s�X I y �- .. <br />, <br />< < ....... . <br />,, .. .�e �r.. f� . � � � � t ,--,� . U ...._. <br />� f £- <br />.�.. P- n . .. .„ . ... .... <br />� <br />� � (� n 1 �. A ! . �`.�L � �� ....... .... ..... .... <br />�. <•" i <br />� .... � � i!9 ..... . <br />. � � � ................ .. <br />No. Hou:s Labor....._ ................................:�...Cost:s..........:......_.. <br />.... <br />, ...........__..._S Ft. <br />Cutm......._........._Frvemcnl ....................X...................._.. . � 9,� <br />� .......X ........................ ......_... ........... ., <br />� ............. <br />n'''�y ' � .................._]i........_.............. ....................... �� <br />. z;K !.= <br />����1= �� �!, Total ........................Sq.Ft. <br />_ — <br />__.___ _ ____. <br />. .........._ ............... ..._..... .... <br />............................. <br />Remars .................................... <br />_ . ..................._.. ..... ............................................................. <br />_ .................................._. . <br />., . ................ ........... <br />p��dcr nccerved............_ ..................._............................. <br />........................................ ... <br />\':or?: Compleled__..._ .................................. Foreman <br />