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/.5576 <br />Acet. No... <br />CITY OF EVERETT—Wetc Dept. <br />Application /y If- Date. ( IB.�z <br />Install...... Ie}........... inch water service pipe { <br />Owner.........................................................../......................_......................_......_..... ' <br />Address.......... �.�....�......7.7-� r......:............................_.._....................... 1 <br />Lot............................................................. Block No.. <br />Addition ........... <br />Cov',ractor..,,,_ <br />r..... LAJ.. ........_. <br />........ <br />. ... <br />.._.....T....._......_......_.............................._.........................._............_............ <br />Amt...........� 1_:.................. Rec. No .... _...................... ...... ................... ............ <br />By.......................................... _..__..................................... <br />Superintendent <br />ShopRemarks ............ ........................................................................... .._.. <br />............. _.......... .......... _.......................................... _.......... ........ ........ ............ <br />Work Completed ........._.............'.... F <br />...........................:........,.................. <br />orema � <br />i <br />