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7Ape <br />CITY OF EVERETT—Water Dept. <br />Application No .... J.q.0.Y... ...... Date .........:�..::A...... (L!..`.%............... 19.... ... <br />Install ....... ........... ........... inch water service pipe <br />Owner.... .............. ..............................�................._......»........._.........._......_..... <br />Address........... I..E!I....=......1A..3...-.........._.............. _........ ...................... <br />Lot.............................................................. Block No .......... ............................... <br />Contractor... ....... _._.................................................. ....... ._..»......_........._.._.._.. <br />Amt...._. _ ..__.._..». ».._... Rec. No .... ....... ....... <br />_ ._ .».._...»_....»._... .._.... <br />By...... ............ .................... :+ a <br />sups iiendent <br />AAA ) <br />Shop Remarks.......... <br />.....................»......»._..._......_............._.............. <br />............... _.......................... .................... »........ ..................... _............... . _.......... ..... .. <br />WorkCompleted ....................... _................................... ........................................ <br />Foreman <br />