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w. c. rnnu <br />CITY OF EVERETT—Water Dept. <br />Application No..(.._ .: Date)&.......:. ...............18........ <br />InstalL ................ .......... inch water service pipe <br />n <br />Address.._.._ 4./..�..-... /.., <br />Block No .... _....... ...... <br />_._......_.._.._.._.. <br />Addition......... _........ _................... ..................... ........................................... <br />Contractor ................... _...... _........ ......... <br />Remarks./.J�....._. _..._.._._..............._.. <br />............. /_i1J_................ ...._.........._... <br />Amt..._.._........................... Rec. <br />Shop Remarks ........... ... _.................................. <br />_._.._.._............_.._.._......_.. <br />Work Completed ............................................ <br />