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CITY OF EVERETT--Water Dept. <br />Application No.... Date .......... =%..:�.::..(�:.: S ...........19...... <br />Install. ...... ........ ..............inch water service pipe <br />For........... . ...................................... _........................................................ _..... <br />On.................... ........ /Z........!`..''y.. (..............._._.._....._.._... Street <br />Lot............................................ ......... _.... Block No ................................ <br />Addition.......................................................................................................... <br />Remarks _ ._.. <br />. ...... ._ <br />................. ir,4................_.................................._ .......... _... <br />..................................................... _.................................... ...... ........... <br />............................................................ _........ _.......... <br />_ _.....:.4.4.�{. <br />Superintende(it <br />LABOR AND MATERIAL 17SED <br />No. <br />Size <br />..... ._......_.... <br />_.......... ... _......... <br />mead Connection Complete <br />..................... <br />_........................ <br />Saddle Complete <br />.............. ........ t. <br />_........... ............. <br />............................... ............ .......... .......... _..Pipe <br />.._.._.................. <br />........... I...._. ..... I <br />Service Cock <br />_...... .... <br />....................... <br />Service Box <br />No. Hours Labor...... ..................... _.......... _.._.Cost._... ..... ............... .._................... <br />Cutin.. ..,.Pavement ..............._... X ...... ... ............ ... _.................. Sq. Ft. <br />v .. <br />................... X.................. ..... u <br />................ x....... _.. ............ ........................ .. <br />Total ................... ...-Sq. Ft. <br />Remarks ................................................ _..._........................................... .... <br />. <br />................................................ .................. ........ ............-........... .I .................... <br />. <br />.... .........................................................................................................._........... <br />OrderReceived... ................ ..... ................. .. . ....... .. ... . ...... ...... <br />Work Completed.......................................................... <br />Foreman <br />