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a a. rartu[ :�� � T � � /. i. <br />W. 0. �O(iH J .- r • • <br />CITY OF EVERETT--Water Dept. <br />A lication Nd..'.—Tnst/i . ��'....;�..........mch wa� ` <br />PP �. '.... .... . D te....--�./'=`—` .. :....................19..:... / <br />„ � , . <br />all._..'-�. ter service pipe <br />For �-J, , :-�� ;�( : ,. ;'2 . <br />......................:...........�........._..._....... �� <br />.....................�--�--.:..._� ... . . . . <br />...... <br />_J'_. I/� f. . <br />On .........:..:..r....,/.................._�...�:....:_..................::.:-....................... Street <br />Y <br />Lot............................................................ Blor,k No..................................... <br />��I�lition ........................... ........................................................................... <br />Remarks......................................................................................................... <br />�%r. < <_r. .: ; i , . , , . , : <br />ry <br />/' ..�:i:.:.,. .. <br />/ � ; 1... �-d <br />No. <br />i):_ � ' ' <br />� !�'' _ <br />I.AB02 AND MATERIAL USED <br />Si2e I <br />--r--- <br />..........._.......� Lead Cnnnection Complete <br />..............__._' Saddle Complete <br />..................... ........................................................................Pipe <br />_ .......::........_ Servicc Cock <br />_ ................... Service Box <br />...........................I ..........................� ................................................................................................................ <br />No. Hours L�bor ..............................................Cost.................................................... <br />Cutin ....................PavemenL....................X........................ ........................Sq. Ft. <br />� ....................X........................ �� <br />, <br />. . . . ........................ <br />; ....................X........................ ........................ ,� <br />� ....................X........................ �, <br />........................ <br />Total ........................Sq. Pt. <br />-------- --- <br />,, ; — --- <br />P.emarlc;.. _ _ _ .._ ......:..:....:.'. <br />................................................................... <br />OrderReceiced ....................................................................................�...... <br />�Vcrk Completed._` :.............:..:..._...................._.............................._'�... <br />Foreman <br />