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, w. o, sortw a � � � <br />/62� A���. No_..._T�r�y..... <br />CITY OF EVERE:TT—W�ter Dept. <br />Application Nu.._! .��'..,� � � S / <br />............. Date....................._t... 5..........- .......19..C''�'.. v <br />', � <br />InsEall........ f..::_,....,...,. inch water service pipe <br />'— ✓ <br />Owner....._�..G.l.:l.t.r.f':.........�2:._.Y..r_r.�.� :............_ -y. 1.:........._.................. <br />Addresx......:.,��....-% � _� .............�:zc.r>�'--<,��'..+..:.....✓.t�±:..�; <br />- .............................. <br />Lot............�....�.✓.:..-�- .............................Block No.....- -...�_..--��..,'_._ <br />c�- -- ... <br />Contractor ..............___--_ � <br />�, - ............................................................ <br />Amt.-�---5_.�:--_� _ ................ Rec. No...<�....% ././._._.- •----....__.............-----..... ...... <br />BY /��� �. <br />. ./...�iz :l.�."��� .:..........._...*'..,�.��.fc.�l..l1 �•�r>v <br />Superintendent � I <br />Shop Remarks ............... <br />� <br />WorkComplefed ....................................._....................................._........ <br />/ <br />Foreman <br />