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/ 9So „�;,; <br />8. ��. PPI[flC�]r � • � - . <br />W. O. IOPM 'J - <br />CITY OF EVERETT--Water Dept. <br />;- � , , <br />Application No."_.__ ...:.:....:. . Date.....^:......:...:....._.:..::.:.............19...... <br />� Install.....:� ::...:.:................inch water service pipe <br />For ........::_.....' .....:.......... <br />On , <br />Lo t ....................................... <br />:lddition ......................... <br />Remarks ........................ <br />...... .._ . , <br />: <br />_.. _ .............: .. i..' ...'..' <br />/ <br />_ ..........,, ...:........._................_ <br />� <br />.. � /.a,:._..... <br />� <br />' ( f�.....^ <br />. .., i .. �... . ........ <br />i.. _ <br />Street <br />Block <br />..... .... <br />................................1.....�..:.......................... .. <br />............................r.:l...; .:_:..., .. __.....:..:....:.rl...... <br />Superintendent <br />LABOR AND MATERiAL USED <br />Size <br />..............._ Lead Connection Complete <br />..................� Saddle Complcic <br />.:................ ........................................................................Pipc <br />.:::C............ Scrvice Cock <br />................. Ser��cc Box <br />� <br />No. Hours L�bor .................��..........................Cost.................................................. <br />Culin ................_..Pavemcnt..._..........._..X........................ ........................Sq.Ft. <br />� ....................X........................ ,� <br />.............................................. ........................ <br />Total ................__....Sq. Ft. <br />-- --- -- — ---- — <br />• .. <br />Remarks..........._ .....................:.�.....: �.:..:......_........_..:_.................................._. <br />_ . ..................................................�...._i.�t.:.....1.:.:....:......... _....:.....:_...........---..... <br />OrderRecciced .............................................................................................. <br />\Vork Campleted.::'.:...::.' .:.......:....'........__._......._..:..:_:..'..........._........_. ( <br />Foreman i <br />