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2816 21ST ST 2016-01-01 MF Import
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2816 21ST ST 2016-01-01 MF Import
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Last modified
4/21/2017 12:35:41 PM
Creation date
4/2/2017 4:39:16 PM
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Template:
Address Document
Street Name
21ST ST
Street Number
2816
Imported From Microfiche
Yes
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1�8J �' <br />S. L Priefie4M Z46 995 <br />W. U. Form ) ' ' " <br />CITY OF EVERETT--Water Dept. <br />Application No....._ .......:.:........ Date.................._...:...... ........':......19:.:... <br />Install ..............:................inch water servicP gipe <br />For...........::.�:...;............:........................i...:...................: <br />- .........--•- ............. <br />On .................. ........::. ::: ".' ' ' / ' ' ........ ......... Street <br />Lot........_ ........-- ..................................... Block No..........---......................-- <br />Addition........_ ............._ .............................................................................. <br />ftemarke..................................._...... - � - `--- - - _ <br />� <br />� <br />,,,, " ....:...:...._...�......_.._._...........................--..........._.... <br />.................. ... <br />, ' �,� � . . Supr.rentendent <br />� <br />LABOS AND MATERIAL USED <br />........_(^ i A � Lead Connection Complele <br />............ I AsK-/..".�._... I 3audlc CnmPletc <br />� L � �.,r�..... , . . � ' .................Pipe <br />...... .... .... .. <br />%�� i <br />..... .. . <br />C , <br />................._,..St. _...........::....,,�:.I ...........�.: �?.:.-.. o . � C. r . <br />. .:..� .................... <br />...._............_......_.........�/,./.�L..... Servicc Coc ` <br />.._.........�............ j ft-'%-:.iopx �) [� <br />..._......... . . � , �....._... ��1, Vtee 1.:L.l..7J....IC..!l:-r..y��l::l.:":.�!_!::lC :.../.� ............... <br />J ................::...:::....... <br />............ ...............--.:... ,,....... . f.`..�a..;�¢_!'-.-:.r..... 7� a......:;�..�.c..r,`:-x.�_%......_�(.�.._...l............... <br />_....._ ..............---i.......__..............i ....................._................ ........_.................................................... <br />� � <br />P <br />.� ! <br />Nu. Fiours Labor ...................._.............. ..Cos!.......; .. ............................._...... <br />Culin ................._.Pavement....._._..........X..._................... ........................Sq.Ft. <br />� ....................X..................... .................. ., <br />_. .... <br />7 ) t z ' : . v_s !� — _....x ..................._... ,. <br />........................ .. <br />�� � �u _......_.........x ........................ ........................ <br />/° <br />Total ........................Sq. Ft. <br />--- ------- ------ ---------�-- <br />itemarks.__......_ .............................................................................................. <br />. ,. <br />.. . � . <br />�, :.._ <br />_. � <br />......._......_ : i'.:.! ...... ................�.........--................................................. <br />.-. . 1� <br />: �....-:f.�..::':�:...� .................................._- ........................./ <br />OrderReceived.........._....-- ................................_..- ................................� / <br />i / <br />1\'or}: Cnmpleted...�1...�:1._...r:�._ ....................._:;_..:.:':..:r.,...:.._.............f... <br />Foreman <br />
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