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5 J. Pri.be1M ](p.j995� 8 V . . <br />U!. U. Form ) <br />CITY C�F EVERETT--Water Dept. <br />Pt f �` :: �;;, <br />� �lication P:o........i1�..ta.1��../Date.....' ........:..........._�::.............19.....: <br />� 11......_ i ..:.................inch water service pipe <br />, ..... .... ........ <br />or .......................................... .. � <br />� <br />........................... _................... <br />i 1:....J' l.f..:..'. �, , . ; , , . <br />. �-- <br />On............. ..... ..... � .........L......................................... Street <br />Lat......... .. �<... . ,�..� ................... Block No.........`::..::._?:.:........ <br />... <br />� ' G�o� � -� <br />Additior� ............. i.._.%.......................................................... <br />�, , <br />% ��-l'�'"...�' . <br />Remarks d <br />.............................. <br />... .^::....r ...:.:.............:....... ._........................... <br />;.�.:;....:...._..:..�}.:� � ................................................................................--- <br />._J'_���`� ......................_............... J......._.................._.......................... <br />' � ... ' <br />"' <br />i / � \ <br />... 1 .................................................... F _�''.�......�. :-.:l..�.:�.:....""'"'...... <br />��� � � �. Superintendent <br />LABOR AND MATERIAG USED <br />---- -- <br />........................................._..........1 Lc:,d Connection Complete <br />Saddlc Com�lete <br />.......................... ........................... , <br />.._.........�..y....ft..........�7-.� ......... ....�'..:^::.d... �C::..::.....................................Pipe <br />/; .� <br />.............._�..._.........._.q.Ly........ Scrvice�Coek <br />..............�..............'���,.z1............... Sm�cicc IIox � <br />r, . ' ` <br />� <br />.....__' _ ............ ...C,S..c�..�'... `a l a �.r............:� <br />...............(............ s �,�............._. { �..........'........._(.(�.....;_............... <br />J i- _ <br />� .__........�,,__.... ._C..:�..:��:..i.e...._'.........;._C:..._�.:..�:..:- ........:.................:..:............... <br />............................ ,. � <br />_ ......................... ........__.. , i <br />No. liours Lnboc._ ........................._......1.�,..Cust.�... �.:'..: I :.`�.................._._......... <br />Cut in ..............._..PavemenL........1.::�.X....._5i.-..�........ ..._............�...S9.Fl. <br />....Y ........................ �� <br />� � 1,,1 X ........................ :::::::::::::: ::::::: „ <br />�. �, <br />t� , � ...................... „ <br />-� } � ,;, l � � _._.. <br />., Total ...._........... r.....59. Fl. <br />��-- - -- ----- . <br />Rem2rlfs ................ . ... ....................... <br />.................. . .... <br />�-�{} � , <br />......... :: �.�!:..tS::.2.E��..t.:......S�Y!:' .............._................................................. <br />.................. _............ <br />OrderRecciced.._ ..)..�..............................................._..r.......j..j <br />\�ai9c CompletcJC]'...�..��...-.....�.9�L�.....�C..._(1�?s`�:P:-.�:�. <br />Foreman <br />