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I <br />, <br />� <br /> . �-/'G�/o' _ . _ . � ' <br /> w. o. ro�w a y ' .�(.'yL. <br />�I CIT�Y OF EVERETT--Water Dept. ' <br /> Application No..._��.1'1..�:.. Date.........=:..:.:............................1P9...�.�..� `_ <br />( Install...............................inch water service i <br /> For ...................................._�:..................................................................... <br /> �I ) , . ... <br /> On ....�.._i_�.:�.....�L::.....:�:...�:c��..................................... Street <br /> ......... <br /> Lot.............................................................. Block No.........................-�--•--•--.. <br /> AdJition ............................................................................................ <br /> .............. <br /> Remarks ...................................................................................................... <br /> .............. ......................................................................................................... <br /> �_ !a G �c� , <br /> `�.'.................................................. ........_..........................................."•"....... <br /> ��g.,�....��.�: <br /> ............................................................................................'---- <br /> 9_�r� J�' Superintendent , <br /> � a� <br /> LA60R AND MATERIAL IISED <br /> _No. Size � <br /> .....................................................I Lead Connection Complete <br /> ..................................................... Saddle Complete � � <br /> ......................it............................� ................................... ..................................Pipe <br /> ..................................................... Setvice Cock <br /> ..................................................... �arvice Box <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Favement....................X........................ ........................Sq.Ft. <br /> ....................X........................ �� <br /> ........................ <br /> ..................X....................... �� <br /> ........................ <br /> ....................X........................ �. <br /> ........................ <br /> Total ........................Sq.Fl. <br /> ----- --_ <br /> Re m a rks............................................................................................................. <br /> ................... ..................................................................................................... <br /> ............................................................................................................................. <br /> OrderRecei��ed.......................................................................................... <br /> \Vork Completed:......._..........................._.............._._................................./ <br /> Foreman <br />