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3 6 6 2 Acct. No...,-'W. f <br />CITY OF EVERETT—Water Dept. <br />Application No�l..l 2-... Date ................... ! 18Gf! <br />Install ................................ inch water service pipe <br />Owner ................ ........ <br />Address..._ 3L�..Q.?.....-..%/._.i........................... <br />Lot........................ _.................. ................ .. Block No ................... .... ..................... <br />Addition................... _............................. ....................... <br />.............................................. <br />Contractor ...... .-------- <br />Remarks ....... ...._,: Y„- <br />Amt.................................... Rec. No............ <br />By........................... _.......................... .......... <br />.._. <br />.................. <br />Superintendent <br />ShopRemarks ............... ....................... ............................. ....... _............... <br />WorkCompleted ........................................... .......... <br />