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� /7� 03 x ,; .. <br />W. O. IO�M ] <br />CITY OF EVERcTT--Water Dept. <br />Application No...L..'.'..1. . .:_':... Datc........ .:.."'...._�....: :... � �...........19...... <br />install .............................:.inch water service pipe <br />..... <br />For .. ..................... ,................................................................... . . .. <br />. <br />� ' =' Street <br />On..........................1.:._.:._......:.....�..?.............................................. <br />L,ot .............................................................. R1ock Nu..................................... <br />.1dclition .. .. ............................................................ <br />.... ..... <br />.... <br />,, ,cL .................... <br />� 1/.,�..: ......... <br />I:em.�rks ....................................... <br />.......................................................................... <br />_............ _ _ ............................ <br />�� <br />...... �....... .... <br />.. _ .............................................................................. ... � � <br />� , ; <br />... ........ <br />...�.-....:....., <br />........................................... . 5uPerinlenden t - <br />. _ .................................. _.. .. .. <br />'. / i — <br />..�_�_� <br />LAIIOR A!�D MATERIAL l'SED <br />I.ead Connectiun Complete <br />Snddle Completc <br />_... <br />_.._ _....._....__.. _..PiPc <br />Scrvicc Cock <br />Service Bux <br />.... . . .. ... .....Cost .................................................... <br />No. Hours Wbar._........._._ .............. . . <br />. . Puvemrnl ....................X.... .........._....... ._.....................59. F[. <br />Cul in.__...... . ,� <br />....................X........................ ........................ <br />....................X........................ ........................ <br />�� <br />............... _ ...X........................ ... _..... _....... _... <br />�� <br />Tutal ............._.........Sq. Ft. <br />-�•�-----'- - --- <br />-- <br />..........._ .......... ..................... . <br />Re tn a r ks ....................................... ....................... <br />_ ... ...... ...... ........................................................ ........... <br />__ ....................._ .............................. -._ <br />Order Recciced_. ..... __.. - <br />.... ...... _ � <br />\Vork Complcted - .... . - <br />_.. <br />Foreman <br />