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s. d, raicn[.-va / �'3 � _—w ✓"- /.��.�' <br /> w. o. roeH a � ✓ . ., <br /> ' - CITY OF EVERETT--Water �Jept. <br /> /���.,�. �T,f'.:�:3. .........1sG� <br /> Application No ... .......... ..: ... Date............�.:...-. <br /> Tnstall........'„�.lj�..,........inch watei service pipe <br /> ---�� ' ' - <br /> -�-1��-.----�—-- C`'�.:. � - <br /> For ....._F:,�......._ ,r...... .......... .. �.a�.:..s...�:2:�...:.4..�,,,<� <br /> Or. �.T_�.�..-'_��.:........_._............................................. Street <br /> .........4.. . <br /> Lot............_..............L..�. ...................... BlOcn DTo......._--.'......-------- <br /> - <br /> Addition ............ir:c� �....�.,1'.�t.� .��-.:...tr��.'....'...`..-.::._-- <br /> Remarks .....,.�Zrr.r!-....0-'�t..:..-:�..._—................................................. <br /> .................................�scr.n:�..:....:.i::�.,.rr....f..l.....................----•---�- <br /> ,� / <br /> ....�y�_fr............:.............���.(((.z�.�...................._.............................................------- <br /> !: F . �J <br /> ..:................................ .i............................................................"""................... <br /> . . <br /> 'p r.. ..�LQ✓ L Y ...............<�U/3�'t._ ........... <br /> :.. _;...... .. ,�r............................. ...... �- <br /> -� ��,� SuperuRendent <br /> LABOR AND MATERIAL USED <br /> No. Size <br /> -- -- <br /> ...................................................... I.ead Conr.oction ComPlete <br /> ...................................................... Saddlc Complele <br /> ...........:�.:.......ft.......:......:............. ........:.�...._.................................--................_...Pipe <br /> __, <br /> � " .�.......,,,. Scrvicc Cock <br /> .......................................... <br /> � Service Box <br /> ...................................................... <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Pavement..........._.......X........................ ........................Sq.Ft. <br /> i. . :, .. . ....................�C........................ ......._............... ,� <br /> i .� <br /> ....................Y........................ ....................... <br /> -�� � ....................X........................ �� <br /> � ........................ <br /> ;� � Total ........................Sq.T't. <br /> — —---- ---- _ <br /> — � . ,' <br /> Remarks.............................�..:�....:t.....t..._._..............;:...._.............................. <br /> ................................................'--.._...:. .................._:..t:....:........:.................. <br /> ....................................................:'..........._................................-� ...................... <br /> OrderReceived.....................................................................:...............�..... <br /> Nork Completed.,�� ' � '' � <br /> �..:.::...:....�.................. ....... ._................:....... .........�.. <br /> Foreman <br />