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w, a runes a / Aect. No..,.,. <br />CITYOFEVERETT — Water Dept. <br />Application No.yl.P ?.. Date..._ T .-/...................19.1r S� <br />Install .......... .................. inch water service pipe <br />Owner......................... .............................. »..........._..»........... ..... .........._......_....-. <br />.:....................... ............... ... ... _... <br />Lot...................... _..................................... Block No ....................... ................... <br />Addition ..................... ... ................ <br />Contractor..._ .............._...... ............................ .... ._.._..».._._.._..»..... .. <br />Remarks....... _t�'C. �er:.......... ............ ....... ».._................................. ..... <br />Amt.......... ._.._.._... Rec. No ................... »... _._... ........................... ... <br />_._._.._............. <br />..............». _ <br />y..._.._......_.._._.._ .».._.._ 8uparintendent <br />....................................1. <br />Shop Remarks......... <br />Worts. Completed <br />