Laserfiche WebLink
NoPi���,� APPLICATION FOR SERVICE SL'RVICE �1J° ��;; % <br />CITY OF EVERETT WATER 6EPT. oRoea <br />. IXED / OATE_./�( Q�i._/.y 18� <br />n oerosir s(� C�._(�<,� w o. <br />�^ ��7 No.----/'-------- <br />BERVICE (BY AooREeei—`�� � �_._�" Cr�C�I�� ���_ __ yLK._. ___.LOT � (/_j./� /� ' <br />{� _. __ _. _ - __ . _%.ADD. _��.__ .- <br />OWNERlLU�If1F��/N__._��✓Jj�1jM�.�A/����_ _ GO�Y� <br />- �� __CONTRACTUR_ _ `. _ %� <br />J FLAT ._---___.-___.. <br />INSTAL��q�p SERVICE____ _ ,__..____ - -y-- <br />I HEREPY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE /, � � <br />ORDINAYCES ANU POLILIES OF TME WAiER DEPARTMENT NOW EKISTING �(/�--.�y� �� <br />OR AS SAME MAY BE HEREAFTER CHANGED. BieN[o: <<.` �l` 7 �Y �. �-( �-� <br />'-.. _ _ _ _ . 4..C._'L_____ <br />�� MATERULS � IN.'i � IN. I f IN. i I P E AMOUNT <br />P�PE COPPER •- GALV. -- STEEL j <br />-_ � � --�F--- - <br />COHPORATION -� �-��-- --� �� ---r �-- --"�—I— <br />_.__—_--_._—_— I ' I —�� 'i. I <br />CURB COCK <br />SERVICE BOX <br />METER VALVE <br />METER No. <br />METER BOX <br />OT <br />PLASTIC -- C I <br />_-.__ ___�..__ __TYPE:-_—__ � ___I SS <br />CONCRETE _ _ SMAI.L LARGF. _ <br />� ON <br />DATE INSTALLED:/�7,/ � OF'F �/ <br />CODH I L BOR AND [pUIPMF.NT HENiAL <br />--I •� 'tf - <br />. -..-- . . . . _. __ ._.____ _.. <br />l —}- <br />- —�- /- �r� �-_.�1. . _._ nl�CGL- ' ..__ � 2IIL—_. <br />___ __ <br />_— <br />_ . _. _.. __ <br />_ _ _ 7 �_� � : - -- _----- <br />REMAIiKS: <br />L'Z�l� /C G SUB TOTAL <br />�i�� � x <br />� N�UR6 RATE <br />______ I / <br />_ _ / �I I <br />� / __ _! --I -- <br />- - —_' <br />"_ I <br />� i <br />TOTAL � I <br />