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w. D. rww a <br />.5'9 UY <br />Acct. NO.... _!...:.. . <br />CITY OF EVERETT—Water Dept. <br />Application No../...:._ Date..__. .............. L:..1.......... IB....... <br />Install ............. ............ inch water service pipe <br />Owner... _.. ........ ............... ....... ..... .......................... _.............. ............... .............. <br />Address........a 1..-...�r 8.. �1..............................................._......_......_... <br />Lot................... .......... ........... _................. Block No .......................... ................ <br />Contractor .................. ..__.................................. _.............. <br />_._ __....___.._.._.. <br />Am:._._. ___.._......_.._....... Rec. No...._..__.__..._. ......... _. ._.__..._........._. <br />By........... _.............._......_. i._._.. <br />Superint <br />K! <br />Shop Remarks ....... _ <br />Work <br />Foreman <br />