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- W.D.Fo.m 3 �cm i i ia:� <br /> CITY OF EdTERETT--•Water L�ept. . <br /> APPlicacion No.D �_� D .. Date �J.._�O _ i92_P- <br /> ,� <br /> Install_ �?� _ inch watcr servxe i e I <br /> ror �-�h.l�_�, ��?-���c. . . <br /> On / � . � ._..._�/� ,.�, s/ <br /> � ./'"-c'ur�_ _.�l �.:�_6treet . <br /> Loc_ �. s �..�... _ _Block No . .....� <br /> __.........__..._ <br /> Addicion......._.................................._........_. <br /> __........., _.......................... _......... � <br /> � Remarks.............. <br /> _ _ _ _................_.._................,.... ..._._....._......................... _.... . ...........__. ._.... <br /> _...... _ ... <br /> _... . <br /> _ __ . .. <br /> _....... <br /> _. e iC <br /> ............... <br /> . •Supe [ e�� � <br /> "_ __-_-_—_' _ —_—_—_—.. <br /> ----___-- __..-.---_.: <br /> WDOR ARD h1A1'ERIAL USED <br /> . <br /> _ No— i Size -� ._ - .__ . _ - . _ _ . <br /> — -• L .. -'/ ------------- - . _ . _.- --- - - _ . _. _ _.. <br /> ..........�..............�..i-...:-EX.tL7� Lend Cunnection Comp�ete <br /> ........_:................�_...�t..Y_�.._ . . Saddlc Qonplete ' . <br /> ._......c�.�S.�......fc.l......�,3-...�_.... _ 1�'-� t.Y. � <br /> � .. <br /> .........._................................._.......P i p c <br /> ....... ..L..............I....� . . .. Servicc Cock <br /> .. ........... <br /> ...__._�................�.�f?Lf.!� Ser�':c Box <br /> . .. ....... <br /> ..........................I... <br /> .................... ......... .......................................................................................... <br /> ......... ... ... ...... <br /> . ...... ........... ..... ... ......... <br /> ........ .............. <br /> ..... .. ..... ...... ............ <br /> .... ......... ................. .. <br />. ........ ............_. ................... . ._ .. <br /> - - ---- <br /> � - <br />� No. Flours L¢bor.............:��.....................Cost_.._.1�.�.—'n _....................._ ._ _ <br /> _........._.. <br /> Cut in............�C..........1'avement....................X....................._.' �............_......Sq. PC. <br /> ....................t....................... .................... ,� <br /> ....................1C........................ „ <br /> ............._..... <br /> ....................X........._....,....... ......_............ ., <br /> Total ...................Sq. Pt. <br /> -- <br /> -_-- -- <br /> .��3� - - <br />, Remark lct .t� 5!A AT� : ..... <br /> _. . .... . <br /> __ Q.�� '� )` .�zV�2 . _ _..... _ <br /> ........._.........__ _ <br />; _ ........... _ ... _._.. _ _ _. ................_.........._....... ... ...__.... <br /> Ordcr Rcccived <br /> __. <br /> ,.T � ._ <br /> Work Complcted L / �� <br /> ._ ,_ . __..��r �'e t.�r � <br /> Finam � �a l <br />