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w. 0. rORK 3 1 8639 Acet. <br />C11-Y OF EVERETT—Water Dept. <br />Application No./ ::� . ......... <br />Date ................... .... ....... <br />• <br />Install........_._.._..__...._... inch water service pipe <br />Block <br />Addition..._.........._.._......_...... .. <br />Contractor..._......_......_ — ... * ... <br />Remarks......._ . /e— �-; K-1,-J-2 . .. ................... ... . .. ...................... ........... .... <br />Amt----------------- ------ *-"* Rec. <br />.... ... ....................... ... ....... Shop Remarks ....... . . <br />Work Completed......................... <br />