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G O.'PRICO[}��.� � S � / /t ,, // <br /> W. O. fORM ] �/ <br /> CITY OF EVERETT--Water Dept. <br /> ,:�c, ;_> , <br /> -�f— ' - --. ..:` -- <br /> Application No.....--Install.........Da�..�......�..h water ser.,I19::t.:. � <br /> .... .... .. <br /> ,.. r i <br /> � inc vice pipe <br /> _ T �-- - <br /> For ..................................................... .........,;....................................... .. .. <br /> � rJ f l - i ."� (.ti /'��:..................._......... Street <br /> On ........................ .. ...........:::....•--..._,.-.. <br /> Lot................_....................----.........----..._. Bloc'.c Na.............,.............----�-- <br /> Addition .........y�............._.......'.. _ ......... . ................ ...-----........_�........ __ <br /> , .. ... <br /> F.emarks L�t 1,�/ - •' '.:.....:.::::t.<... ..��1��--.............::�:.-J , <br /> _,� <br /> ._.......�.,...�. ., „ <br /> ...... .... .. - ' , ,. <br /> i � <br /> ..... <br /> ;.�:r,:t........�.:!:�:���ti.!��.....1 �°�4:t:�:�.^:.:�1.--- <br /> ��................ <br /> /� c- ������j 'Lk��f.b�"_.-.�. <br /> . .� �d'-.�t>J-�✓_.�;!=.�......�)_/1:�.:....::..i.�_......"-."""'......_7:� . <br /> . <br /> .......::...................... --'.. . i;,+ <br /> � , <br /> _,� _ , <br /> %,'-C.�...:�.C�1�''�S'ti�..!:.�....1'�:'1%i�:..�. . _��/�--J � Gr.l-�� '-ti. <br /> -' ................ p .... <br /> " Su erintendect <br /> ���J <br /> LAFSOR AND 21IATGRIAL USED <br /> No. Size I - <br /> .............. <br /> .................................. Lcad Connection Complete <br /> ............................ <br /> .......................... Saddle ComPletc <br /> ...it._. ....................................._.................................Pipe <br /> .................... ....................... <br /> ..................................................... Service Cock , <br /> ............................. <br /> ........................ Service Box <br /> No. He,. �abor.. ...._..............Cost....._............................................. <br /> ..............._. <br /> Cutin ...................Pavemenl ............_X......._............... ......._.:.............54.Ft. <br /> . .................X........................ ........................ <br /> �� <br /> ....................X........................ ........................ <br /> ,� <br /> ....................X....................... ........................ �� <br /> Total .._....................Sq.Ft. <br /> --- <br /> --- ---- <br /> Remar c:.......................................................... <br /> ................................................... <br /> OrderPeceived......................_................._.................................................... <br /> \Gor}_ Campleted......................._........_..._....._.........................._..._......___.. <br /> F'oreman <br />