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Fl� W�O. FOPN J l��2 . b� ��--� <br />V � - <br />Ac:.. No ..............--................ <br />CITY OF EVERETT—Water Dept. <br />g�.'�� ;:, , � � ' ' � <br />,�,:., , <br />Application No....l� t-�� z......... Date .............._ _.......................19........ <br />Install..........._�..� .............. inch water service pipe <br />� : . <br />Ownec.._�.i.�.e.!:.?.i Je......_ l,G' 3:t N.l.'....... (iC 5. �• <br />.. .. ........................................... <br />Address...... R.t..� :Z...... �?.E:�._. �.? G'... .......r�.`: c ("..`.'..� .............. <br />... <br />Lot...............- --� - ................................... Block No.............. - - - -- - - <br />Addit io n ....................................................................................................................... <br />Contractor.......... ...................................................................................................... <br />, �, . <br />Remarks.........._�..........._!%/.'1."...�c.....:?./,,f� w / r.!........�.:�...} .................. <br />........... ....... <br />�/-'n�. ;..-+ «. S C/a M y P i�-a,. % 9 3! <br />Amt......................................... Rec. <br />� <br />Shop <br />Superintendent <br />�Vork Completed .........................................._...__............................................, <br />Foreman <br />