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Ace!. No............ <br />CITY OF EVERETT-*)� Water Dept. <br />Application No..(...d..:7:.�`.?.. ... Date... ....... 19... _... <br />Install ........... _....... _..... ... inch water service pipe <br />Owner....... ... _......................................... . <br />Address........ ..... �1�_..._....... ...................... _..................... ... <br />Lot ....... _.......... _.... _............................. Block No .... ........ ..... ............... <br />_._.._.. <br />Addition.................................. .._............._.........................._.............._.._.._..__ <br />Contractor.......... _........ .................... ......_......_.._._.._.._.._.._.._.._._......_......_.. <br />Amt.... ...._._.... _................... Rec. No ........ _._.._.._.__ ____.._.__................. <br />By...................... �L <br />8uperinJc��. <br />ShopRemarks ........... ... ............................ ......_......_......_.._.._.._......__..._.._._.. <br />Work Completed ............. <br />Foreman <br />