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/G:ra 4f .' <br />CITY OF EVERETT--Water Dept. <br />r <br />Appli:adon Nnl�.'...:'.'�... Date.......lss.<.�ta......................19�z <br />Install...............................inch water service pipe <br />For......... f�aeca�oc- .................... <br />On ......... .�.... n....... 7........fwfo'(d.... ..... 1............... Street <br />Lot................... _......... ................... ........... Block No ........... _...... .............. _ <br />Addition.................................................................................. <br />Remarks.......ryls7is.................................. <br />Superintendent <br />LABOR AND MATERIAL USED <br />Lead Connection Complete <br />Saddle Complete <br />Service Cock <br />Service Box <br />.......................................................................................1............................ <br />OrderReceived .................. _ __ ................ _......._ ............................ ..... <br />tVorkCompleted ........................................... __... <br />Forerran <br />