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5 J.P.iebe�M�.a4H9f� � / / � . . <br />W. D. Form <br />C;ITY OF EVERETT--Water Dept. <br />f // :''� .�. . , � i <br />� APPlication No.��_�...c..,�:.. Date.._'L:.._:...'_:::....-----.._---....19::::.:, <br />Install ..................:...:....•.•..incn wa�cr s•�rvice pipe <br />... ........................... .........- - — <br />or ....................... . <br />_ _ .-, i— <br />,; j �, 1 _ ,; _, , :; — :.� 1 �T• .:..:........ Street <br />n ................. <br />.............:.:..... _.:.. _.. <br />........ � ................... . ........ <br />� ' .' al....L Nn <br />, _ .._'""""""'"'.... <br />Audition <br />Remarl;s <br />�� <br />■w� <br />:�..`..... L .............. l!��:..i <br />. ................................, <br />................... ............... <br />.................................. <br />....... ,',,�'� i'T-....t.::;�. <br />j -'r <br />_........------.. <br />...................................... . <br />i� <br />/%�� �.1-- <br />LAROR AND MATERIAL USED <br />................ �... <br />� <br />.: �..........'-'...-"'----" <br />Superintendent <br />,_ . ........ Lead Connection Complete <br />_,.......... Saddle Gompl�J t�e� <br />, .� � �`�" .1 .....................................Pipe <br />� <br />..... .._........_ .,.:..... <br />.. <br />�� C^rvi Coc'.: <br />... ..�, ..... '�� Box 3�� x (. 3�'�:,, ��, ... <br />�.,...cL..... —f ' '7�-�.la (� f?� 0- <br />-�-<�-n. _.Lcr; '%6;n,r.o;.�..:. � /.... .........:I'F:^"... <br />...� .�y... <br />.�.�.�....._.�._I �......I,...._._(�a.e_�. a.F<._;.. �}Y..t.�.....fC:.cr ..................�...>>.a... <br />. :.: <br />.:......�. , <br />�_ � ,,1-� F�� � <br /><, � � <br />, �, ;��,.1�.�,:..�rFx.t...F...^.... <br />c f�_�, �:� ........................ __.. <br />........_ � , �� , <br />3 <br />No. Hours 1,anor .............................................'-,--- � ........................Sq. Ft. <br />Cut in ....................Pavement....................X_ _.................. <br />I..................X........................ ........................ �� <br />P..o� a,F.' � .....X ........................ ......................_ �� <br />............... �� <br />��7-1,1.A� � �a�`� ....................X........................ ........................ <br />� � � <br />. Total ........................54. Ft. <br />�—_- = � = ----- — — <br />Rem a r ks ............................................................................................................. <br />........._ ....................... ........-- <br />Order Receivod ................... _. <br />\'�'ork Compleied ................... <br />Foreman <br />