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roew s I S 6 S 9 •n. o. <br />CITY OF EVERETT—Water Dept. <br />Application No.I?(-t..�... Date ...................... 3—/....... ............ <br />19�Rf! <br />install ............................... inch water service pipe <br />Address..........o y 9..'...v.A.'.y..ew.................................................. .......... <br />Lot........................ _................................... Block No .............. ............................ <br />Addition... ............ .................................................................................._.._......_...... <br />Contractor........... ...... ........................ .................._.........._.........._.._......_.........._.. <br />Remarks...........0; --*-.!e:............................................... _................__.........._. <br />Amt........ ......... .......... ........ Rec. <br />By ................................. .............. <br />..........._............ <br />BuDerintendent <br />ShopRemarks ........... .............................. _.._.._...........__..._._...._...._......._...._.. <br />WorkCompleted ........ .............. ............... ..................... .._..................................... <br />Foremen <br />