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C11 Y OF EVERETT-- (Water Dept. <br />Application No.z..,-... Date .............. 1..,.. /...................... 19....G' <br />J Instal] .... .............. ,........ .inch water service pipe <br />For.....mac �..uit........ ................................... .................... <br />On ... .Cta`-...-...._Y-01.t`ILE.�....................................... Street <br />Lot........................................ ........... _....... Block No ........ _... _._....... ........... <br />Addition.......................... ....... .-........................�.. .. . _ . <br />Remar.. ....................... _... ....... _.................... <br />LABOR AND MATERIAL USED <br />No. I Srze I <br />Order Received.......... <br />Work Completed....... <br />Superintendent <br />........................................ I ..... .. <br />Foreman <br />