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Acet. <br />CITY OF EVERETT—Water Dept. <br />Application Date .............. 9.--/..................... _... <br />19G�.Y. <br />Install..._ .............. ............ inch water service pipe <br />Owner........... _................................... ........................................................._......_...... <br />Address........ ............ %.......................... .............._.._......_... <br />Lot................... .... _................................... Block No ..................... ........... _....... _.. <br />Addition................... ............................................................................... ... ............ .. <br />Contractor... ........ .......... ........... .................................................. .._......_......_.._.. <br />Remarks ........... <br />Rec. No .... ... .... .............. _...... _...... ........................ <br />Superintendent <br />ShopRemarks ........................................................................................ _.. <br />WorkCompleted ...................... ................... .._.... ................................................. <br />Foreman <br />