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w. o. roM� � ��, � '� .. , ' ' . . , <br /> ' � " CITY OT EVERE�I'--Water Dept. <br /> Apqliration No.::...; .._.�..... l. Date__................:..........................19...._ <br /> ; Tnstail............... ...............i�h water serv;cc pipe <br /> . , <br /> P, , " . , i ;' ,..r...: - ............._............_..- ... <br /> or ..._:...i..._..i.A.:_ _.._..._.._.._.... �.:..... ........ <br /> On ........_�..:«.....::............_.....4:.::...: ...::� :.,.:.:,_ _............................ Street <br /> Lo+..._ .......�..�..........- - ....................... ]31ock No..................................... <br /> Addition .__..__... .._....._._..........)-.... ........._...... ,_...... ............................ <br /> Remarks �_C..:.:.<..:.. .:..:...:..L.:.,.::;......................._....... <br /> ........................... <br /> .._.._.........._...._.... .................................................._......_......_........................ <br /> �,; : <br /> ................__............................................ <br /> r.'.Y...........:.:...1.. :............................... <br /> (. ' I.r ........ ...... <br /> � � <br /> ... . . .. ... <br /> ................................. ............................................................... ...... . . <br /> Superintendent <br /> LA3DR AND MATERIAL USED <br /> 1Vo. I Size ' --- <br /> . ______.—_. <br /> —_..._—.,'_--_.__ _, <br /> ........_.. .............�........... <br /> _,,....... _..'� Lcud <;onncction ComF�ete <br /> ................._..................... <br /> ...___.....�I Sadcllc Con�g�lete <br /> ............._........ft....... . ...__................_........_...._........__..................Pipe <br /> . ................_ <br /> ............................. <br /> ................._.... Scrvice Cocl: <br /> ......_................... <br /> ........................... Secvicc Box. <br /> —" <br /> ............_......._CosL.........................._.......__._......... <br /> NO. A011CS L�L]OC._..._ ............ . . <br /> ' .__Favement.......__.........X........................ ........................54.Ft. <br /> Cu: m._............ <br /> �� <br /> ...... ......._.._X........................ ........................ <br /> ...... ...._......X............_......... ....................... <br /> �� <br /> ............._.....X........................ <br /> ........................ �� <br /> Totai � ................._.....Sq.Ft. <br /> _=--�---�— <br /> Remarks............_.................................._........... ..........._ ............................_.. <br /> _ ............. ...................................................................._..._.........._......... <br /> _...................................................._............... ........................--....... <br /> . .......�......... <br /> OrderReceived .....................__............ .......... ............_......... ' <br /> \��ork Cempleled............._...... . _._ _..........._........ ....._._..: ,.._ <br /> . __._............ . Forenan <br /> f <br />