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5_7 <br /> CITY OF EVERETT�Mater Dept. <br /> Application No....ILK�-1 Date.....:�....::z <br /> Install...............................inch water service pipe <br /> For ..............,./..._...............,............. <br /> �K <br /> On .........0.5'..... ....... _. ...o <br /> . .............................................. Street <br /> .. <br /> Lot........................**'**'*'***...**'**'**'*' Block No........_.._.._._. ... <br /> Addition ................................................... <br /> Remarks .............................................................................. <br /> ........................................................................................................................ <br /> ................................................................................................................... <br /> ........................ .............................................................................................. <br /> ......................................................................................................................... <br /> Superintendent <br /> LABOR AND MATERIAL USED <br /> No. Slxr <br /> •••.••.........................•••.............. Lead Connection Complete <br /> ............................................... Saddle Complete <br /> ................._..SR....................... ......_................._.._._......_.._......_.._.._.._...Pipe <br /> .......................................... ....... Service Cock <br /> .............._..»........................I......_. Service Box <br /> ....................... ....................... ................................................................................................. <br /> ....................... .......................... .................................................................................................. <br /> ................ ......................... ..................................................................................... <br /> ..... ............... <br /> ................. .. ........................ ....................................... ................. <br /> No. Hours Labor............................................Cost............................... <br /> Cutin....................Pavement..............._.X........................ ........................Sq.Ft. <br /> ...................X......._.........._... ...................... <br /> ...................X..........._........... ....................... <br /> ...................X........................ .. <br /> ........................ <br /> Total ........................Sq.Ft. <br /> Remarks <br /> ............................................................................... ...... ...... ..................... <br /> ................................................. ........................................... <br /> Order Received............................................ <br /> WorkCompleted...................................................................................... <br /> Foreman <br />