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C. J. PPIC6C� G ��� //� <br />W. O. fONM <br />CITY OF EVERETT--VUater Dept. <br />Application No...� �; ���:�- Date.......�: ::`A�.::-'.:�........19:::'.% <br />.i ,�" <br />Instail .............1.... ...._....mch water serv ^e pipe <br />l " �-"' - <br />- . . .......... <br />� .� -..._.:::�._ ................. <br />fior ., e.�. r :..._....._.. <br />.............: ....... ............ � <br />- .���-�,.:.:� :t:::__.. St:eet <br />On .......,�....�'...../���,� `�..�-- .._ ............. <br />r _� ............... B10ck NO..................................... <br />Addition..................................................................................- - <br />Remarks /%'Lc.�[:1<...lQ.Gz�=w,.�...,,-...`:^.r.L.:t...��-• ................... <br />........ . <br />� ��� ...... <br />_.._.....��':.....t...� ....................................................... .............----....... <br />...�.... ' . J .................... <br />' . `�rC�,. �...-d.� <br />.. ,� 7aer, i 4 � <br />�;( LABOR ANP �iATERIAL USED <br />:.cad Connection Complrtc <br />Sac?dle Cumplete <br />....... . _ � , <br />. ' � ' _.....,.., Scrvice Cock <br />.............. .....�... . <br />. ............ .. <br />........................... ........................... <br />Scr.ice Box <br />� I .,._,.... <br />. .................... . <br />..........................� .........:................. <br />. .... ;'ast ..............................................._.. <br />No. Hom�s i,abor ................................... .... ........................54. E't. <br />Cutin ....................Pavement..................X........................ �� <br />� ........................ <br />II � �.�cc.�2� / .............................................. <br />', �U i � j,�(r. . ;. <br />, � ..,. .. � .. ...... ....................._. �� <br />• ................_.X........ ......... <br />' ....... ........................ �� <br />i. � ....................X................. <br />Total ....................... Sq. Ft. <br />-__--- <br />� <br />. ...................... <br />Remarks ......................... ...... <br />--_;�.! .......::..:.....:..t .......................... . <br />. : <br />� <br />...:.........^. :: .:.........................----.... <br />_ .......................................... i.....: i...�...: . :1::. <br />..........................."_ _ _ . <br />Order Received .....................................................�S'f.........:......'....:............ <br />\Vork Completed..' .....:::::....:t.�...................,...;....... :.:..' . . . <br />Foreman <br />0 <br />0 <br />