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W. o. "M s 16 <br />9 7 <br />ILA_ Acat. rrn ... ;�.?�v ...................... <br />Cl' OF EVF.RETT—Water Dept. <br />Application No .i �..7�.. Date............ f ^:�.>. .........19..Y <br />Install..._.. �,( .. _ inch water ser. ' e Pipe <br />Owner. .... /?....�'�... _ .. <br />Lot................ ...t*e,�7..........._........._..... Block No ..... ...... .......... ............ ......... <br />Contractor... .. <br />Remarks........... ............................. 11.0 - c /sS........... <br />..._.._.._.._.._......_ems - --- <br />Amt....... rf'_.M............ Rec. No ..... ....... 3y,.._................. ............... <br />00 <br />By ....... ................ ... ii�_..._...... ................... <br />tin dent <br />...A:........................._................._.......................... <br />ShopRemarks .................................................. ......_...........__.........._......-.......... <br />............. ...................................................................... _................... ...... ............... _...... <br />........_.........................................................._......__...._......_......_...... <br />.'! Work Completed...............:..................................:._.........._................................ <br />Foreman <br />