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__ . � ��+ J � � � <br /> 4 J. PRI[PL 1 I . � . ..• <br /> W. b, fONM <br /> CITY OF EVERETI"--�Jater Dept. <br /> �n ' ` ` , . / ,-,,,. <br /> A lication No...i.::L.'.::r.'..../... Date............._......-----......_:�::........19c::.: <br /> ,Install......._.....�::.::1<•:....irich water service pipe <br /> • '�� , • <br /> For � , , _-...... ...................•----�-- <br /> ..:.....:......................�......... ,. <br /> ................................. : <br /> On .................._:::.::...L_�._;:.........�.......:.:�....._................................. Street 1 <br /> Lot.........................1...�......................__..... slock rto........_............-----��----- <br /> Addition .......................................................................................................... <br /> ..� , , , <br /> Remarks ................_.....:._:----..........--�-.....:......---........................................--- <br /> ............................................................_........................................................---..._ � <br /> , <br /> ...................:_.........-�---.:.:.......�.........._--.... .�....._....._........................................ <br /> . J.�.� J <br /> � ' \ <br /> . -' ' "'......_.�................ � <br /> ......................:.................... . <br /> . ,. � � / �"f-1..._'............................._".. <br /> . '/ . : ' .......................:..............:...�' ' . . � <br /> .................. .......""'..�....�........... <br /> ............__....... Sul�crLitendent i I <br /> �;: ; / <br /> t / _ _ <br /> � � . ABO AP7D MATEAIAL IISED <br /> ,..+. <br /> No. Size I — <br /> .,..,,,_. ..,._,..,_.,_,........_ :.ead Connection Complete <br /> ...................................................... Saddle Complete <br /> .......................ft._......................... ..........................................._...........................Pipe <br /> ..................................................... Service Cock <br /> ........................... <br /> ........................... Service IIox �. <br /> No. Hours Labor..............................................CosL................................................... <br /> Cutin....................Pavement....................X......._............... ........................S4.Ft. <br /> .................._X..._......_........._ �� . . <br /> ......._.... <br /> ....................X........................ ........................ <br /> ,� <br /> ....................X........................ �� <br /> ........................ <br /> Tota7 ........................Sq.Ft. � <br /> — ----- <br /> Remarks.......:....:..'.....:_:�..............:.................................................................... <br /> f <br /> .......................................................................................................................... <br /> .........................................................................................-....: <br /> � ��..d_�................. <br /> Order Peceived.......................... ...............C..:;.... '-f..:.............................. . <br /> / ' .� � �• • <br /> �.. ; <br /> \Vork Completed.:�.`.C_�.�..�..............:............_..................................._. ,\ <br /> Foreman <br />