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$ J.Priebe4M7.16�d5�O _ ■ 6 � . � .' .�.-(/ r/ J � 'l <br /> W.D.Form l r <br /> CITY OF EVERETT--Water Dept. <br /> I , � �/. I 19 �l J <br /> Application No...�/..U-`::.°-- Dat <br /> ,/� �IJistal � . .�.............:........------__.._........ <br /> �:_,..,._,�........inch water service pipe <br /> ..... <br /> / , <br /> For ..........�.:):....�.......�....%.'t��::�:;.J..................................................... <br /> ,. � . � <br /> � � �• Straet <br /> , � <br /> ... 1J....:........... <br /> On ............ . _� ..... ...._-...........L........:-:-.................. . ...�� <br /> Lot...............:�..�. <br /> ..............................---- Bl.ock No...l�"::'•:!•-�......._ <br /> �.......-: <br /> A:dition' ..--� .........................._.........:;................._.......---...........t...;. , <br /> � ' ..: � ` c.,c_i� t� <br /> �l; �.c.�_,�r✓ ; < , '-.............-..--_•....._..--� •--....... <br /> ��' <br /> �, <br /> Remac�lcs ...................................................... <br /> ....................................................................................... <br /> .................................................................................. <br /> .......................�"EJ"-.:...........-••--------...._-("�-.......�.......... • <br /> _... , � , <br /> �'.�� �... ............ ......%.r��..�7.......------..__:..... <br /> ..... <br /> - .�......�:...-�-- , <br /> . ........ <br /> ........... ...:.�.-... (t / . Superinten t <br /> v� � �, .� )� ;� i ;i. _ <br /> < ti � s <br /> �A,''(j:, ¢9L OR AND MATERIAL U3ED <br /> ".�F " — <br /> _-.—� �_ <br /> ��� � Lcad Connection Complete <br /> ...................................................... Saddlc ComPlete <br /> ...................................................... <br /> �.......ft.. ........................_.........................PiPe <br /> ................... .. <br /> ................ <br /> .......................... C . <br /> ............................ <br /> ......._.............._. .:fl VICC CUCIC <br /> ........................ Servicc IIos <br /> ... <br /> ....Cost............... ........ <br /> ........................ <br /> No. IIours Labo:........................................ ........................59.Ft. <br /> Cut in....................Pavement....................X........................ „ <br /> ....................X........................ -'---................... <br /> ....................X........................ ........................ <br /> „ <br /> ....................X........................ ........................ <br /> ,� <br /> Total ........................54.Ft. <br /> `--- T-- ..' � - <br /> i..........' •�. �_.-:�::,,<::...:.:.:.::................................................. <br /> — <br /> > ; <br /> Remarks..�-,. ...�............. <br /> � . <br /> .................................:................................... <br /> . . ......... <br /> ....................................................................................... ............. <br /> ........� <br /> -- "";..'�;T! '• . � <br /> ..................., ........................ � <br /> Order Recen�ed_... .... .. : <br /> . _. ., . ,; t� . , . <br /> . � �.....(:...:....................::...................e...:.........�:' 1�_ <br /> �'Jork Completed....:::.:...::....... : Foreman ��. <br />