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w. o. roa.i��i`/ � 1 _ . - .. . . <br />�I <br />CITY OF EVERETT--Water Dept. <br />_: � : <br />Application No:��.`.zi��=bate.....:::�'....'�.......... .� . � <br />_, ,�..'...._........19=:..1- <br />7nsta1l......._..:.:: �:__..,,__ ,inch water service pipe <br />For ..... � . <: :. >f. �i%.�i� r n � <br />..._.. - --, <br />,- �%��-',.. _. :::...............__....... <br />On ..........::.i.. `- ✓� � �, , , . . .. <br />............................:........_� l.� .7:`.t.'..... L�.C�:.. t �: <br />•.-__:. Street <br />Lot.. _......_....__.._..r �.�.-.._ ................. Block Na........................_........... <br />.9ddition ......._ ................................... <br />, .............................................._ _.... <br />Remarks .................... ......._,: �' � <br />. � ................... .................................................... <br />..... ......................... � <br />....... � .. : .............................................. <br />��... , ............................. <br />............................. ✓ <br />.- �; �! ............................................................................... <br />.....:..;..._- � �� � <br />�, <br />....:. .............�..................... ._..... <br />�t <br />LA80R AND MATERIAL USED <br />Size <br />.......... ............. <br />Learti Connection Complete <br />Saddlc Cnmplete <br />._........_........__ ..................._...... <br />Service Ccc9: <br />Scr✓ice Box <br />............... <br />No. Hours Labor_..........._ .............. <br />Cut in..__.........._...Favement <br />S -�.�: <br />: ........................... <br />Superi�itendent <br />Pine <br />.......... _ ............ .. _. _ .. ..................... _ . _ ...... ...... _............. _. <br />.............. _._.................. _... _.............. _........ ... _.. _... <br />........................... ................ <br />................................... <br />._ ...... .............................. ..............._.......Sq. Ft. <br />_.... <br />. � . .............._....X_...................... �� <br />� ........................ <br />. ........... _......... ........................ ......... _ _........... . � <br />....................X..._.._............... �� <br />........................ <br />, Tota! <br />'---- <br />_'_ _____ _ ..........................q. Ft. <br />" .', •—, ..—___— <br />P emarks ........ .......n::....:::'L,::. <br />... , <br />_ __ .................. .................... <br />, .............. _ ...... _ . <br />_ . ............... ._. , � . . , , , _ ; , - <br />........_ .._ :.............:�_.....:.._.....:........ <br />i.... _ :.:........... _.. <br />.............. ..............:........ <br />............................ . <br />. ....... ..: . . .......... _ . <br />Order Recei��nd ...................................................... '. <br />.......... <br />.............. _ � ... _ .... <br />\Vork Completed ::::.........:....:..i....._ <br />_,.......__..._..__....._._ <br />F�,reman �. <br />