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/8Y" � <br />Acct. No.._12�_Aps,;,,, <br />CITY OF EVERETT—Water Dept. <br />Application Nol2e? Date ..... ......... / „Ig,�f/ <br />Install ........... ... _... ........... inch water service pipe <br />BlockNo ... ......... ........... ........... ..... <br />...... <br />Amt......... ......... _................... Rec. No .... ....... ....................... ...... ........................ <br />By.......................................... .............. _...... .................... <br />Superintendent <br />Shop Remarks ............. <br />.................................................. _......... .................................. _ ............. _.... ............. <br />WorkCompleted..........................................................................._....................... <br />Forem n <br />