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- :/Col33 - �°=�=. <br />w.� o. ronw a <br />CITY OF EVERETT--Water Dept. <br />Application Ngll/-':'�.... Date........... f �C..� .............19�% <br />Iast��a`ll....... �� .............inch wa:er service pipe <br />For ........................._:✓:'r: r:;:�:�%f'.... <br />� . .5......... <br />.......... .......................... . <br />- , y --- <br />On ' � % % � r.,� :; l�. �. / <br />.........................................� ................................... treet <br />Lot ............. -���-�- , <br />..,� ............................. Block i�'o......:::::.: �' <br />Addition .................�«<....�t.�.._ <br />....................... <br />...... ............................. ..... ......................................... <br />R^marl:s ......:.' `".::.... <br />. /: c � G'c5..*..4..:.....�� <br />. . ..........-. 1 "^ .....................................:..............." <br />....................................... .........._................................. . <br />ir{ ....................................... <br />... ................................../..�"' .'>t.. <br />.l �I <br />,, I ....................................................................... <br />........... ...... <br />� r _� :::: : :::. ..... ......... .... ............. .... .._...._.... ............... <br />.-r•ca l.g��� �, ��,.»_.��-. <br />..........................................: .. <br />M1 . ...................�...... <br />��_.. ,� � SuperintendenY <br />�D�,ABOR Aha :VfATEAIIAG i•SED <br />Size <br />I.ead Connection Complete <br />Saddle Complete <br />.L �c. !:�c • : - � <br />� _ ........................................................Pipe <br />S�rvim Cock <br />Service Box <br />Nu. Hours Labor ..............................................Cost............................---..................... <br />Cutin ..... .............Pavement....................X........................ ........................Sq. Ft. <br />....................X........................ ,� <br />........................ <br />....................X.......---.............. „ <br />........................ <br />....................X........................ �� <br />........................ <br />Total ........................Sq. Ft. <br />=_ – --- <br />3 Sc< s'Ic.c� '� �•— <br />Remarks... � u .:.......:........ .r.... . ........1. >.......�:.�.�......r2.L<.-. ._....�4... <br />. <br />�' ' " <br />� /` <br />C ...............!'rh�«/�.s'.......,...i.a..........1�.i.s�.�.....�.1.`.�'.•:�. Y:.c`.1.:"........... <br />3 zil...::1.:�..:t�,..:...1..�4� /n Zr7 ) ��-�cs �rP�, �o.-..,�...� <br />................ .......... .................................................... <br />Grder Received............_......_ .....................5'. V r:!.:.-.... �...�='Rl'5....... <br />1VerkCompleted ............................................................................................ � <br />Foreman <br />a <br />r <br />r <br />