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W. O .ONN ] <br />CITY OF EVERETT--Water Dept. <br />l _, ' 0 � l rt.In 1 iri <br />AppLsaMen Date ................................................19...... <br />/ Install ............. ......... i in wa�rja�jrvice pipe <br />For..<...�.4...1../_../:7.? Cam' <br />On "'tea ( Street <br />...................................................................._..... <br />Addition <br />Remarks <br />Block No ............ <br />Superintendent <br />LABOR AND MATERIAL USED <br />Lead Connection Complete <br />Saddle Complete <br />......_......»......_.......»................... Service Cock <br />........... ...... ... .... ........................... Service Box <br />..... ............ ................ I ........................ .... _....... <br />No. Hours Labor........................... ........ .......... Cost .................... ».._..................... <br />CutIn....................Pavement.................... X....................... ...... .... .......... sq. IN. <br />.......... ......... it N <br />.... ................ X............. ...... ..... ....... _....... ....... N <br />.................. A ...... ... _............. N <br />........................ <br />Total .—Sq.Ft. <br />Remarks...................................................................................... - <br />... ....................... .......................................... ......... ........ ................ ........._....._... <br />...................................................... I ......... ........ <br />_.......... <br />. <br />OrderReceived ................. ........................................................ ».._.............. <br />%Vork Completed........................................................................................... <br />Foreman <br />