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8640 <br />CITY OF EVERtTT-Water Dept. <br />Application No.....Zti.. __q Date ............... .... /......... .... .... .... <br />19. <br />Install ....... _._...... __ ._.. inch water service pipe <br />�rfr....._._........................... <br />__ .__... <br />Lot ---------------- ___ ...... ... .......................... Block No ............ ...... <br />_._.._.._.._._.._.. <br />Addition._.......-__ ................._.._.............. <br />Contractor............................ _................................................ _.._.._ _.... <br />Remarks..........._......................_......___.._........._..__ _.... .._.._. <br />Amt.... ...._...... ... .................. Rec. No.... <br />By................. ..... __-------- ................................ _..... <br />Superintendent <br />Shop Remarks ........... _... ....... ..... <br />.__....._._........._....__.._.._.........._......_................_. __...___......_...._. <br />WorkCompleted............................................................................................... <br />Foremen <br />