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V <br />CITY OF EVEREL-F—Water Dept. <br />Application Date ............... ................... 19..,6. <br />Instal inch water service pipe <br />.. For ..t . ............ <br />inch <br />......... .. .. ..................... . <br />On....... .......... ............................. Street <br />Lot..................................................... . ....... Block No................_................... <br />Addition.................................. ,;; ........ ................ ..................... .............. <br />Remarks............. .......... ............................... <br />