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<br /> W� C. IONM ]
<br /> CITY OF EVERETT--Water Dept. ; ;;i
<br /> - �� :' �� ) . 1 / � .ls--••--
<br /> Applicntion No......L.:.:.�..a=.: D�te.....l:,.....�..:...:......1.......:....:.. .
<br /> - / inch water service pipe
<br /> Install..._.�..._.�•`...........
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<br /> � i s,l:...:...._%, fr . _ . , � , �
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<br /> For ......:.... ] i „ -+---
<br /> ! -...1._:.:;.'...:.......t...r...........:....__:_�___....:. Street
<br /> On ............(.f. �--..:-� ...
<br /> Lol..................._......................................... Block No....._.._......_.
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<br /> Addition .........................................................................................
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<br /> rl._��..............i.�:_. �..........._.................................... Superintendent/
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<br /> r � ' 'y, � ABOR t1ND MATERIAL U9ED
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<br /> No. , .'iae' � , _--- --
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<br /> . �.. .?,�r...,.�.1 Lcad Conneclion Complete
<br /> � 1..,, F^.ddle Complete
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<br /> � ... ......Pipe
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<br /> Ja .�i�!-1.._......._ ScrW e Cock
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<br /> .................NO'�Hours L�Uor..._..............
<br /> ...........................Coat......................._........................ ..
<br /> ........................59.F'i.
<br /> Cut in............_.....Pavemcnl_................ X......._............._ ��
<br /> � ---..X....................... ........................
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<br /> /// r/� .................x..............._....... ........................ ,�
<br /> ....................x........................ ................
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<br /> Total ........................Sq.Fl.
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<br /> Remarks............................./...._'. .i...... .�.1... .ra..................
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<br /> Ordcr Peccived_......................._......_..._. // �
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<br /> \Vor�_ Campleted..�.�.':.a...Cl.."..�.i..y......_...«... . ... Foreman
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