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^r,'4, • I(Q� �7 % � APPUCATION FOR SERVICE <br />rfo: . . <br />��ITY OF EVERETT W TER DEPT. <br />/ l•,I l j. � <br />� FIXED � �_r C� l t7 .lr � �'�T � � <br />� ' :' _ +' _ �: �-��'_��_ , <br />��, <br />❑DEPOS�T „ � „ • __.__._-.,__ --_� <br />S'�L�/-' :Je.' " �....�._.._ <br />�- // <br />SERVICE �p/1�/� DDRE891 `� � C� r�--fl(�} �C l' �-/ 1,;:' �L�. <br />l / � <br />OWNEfZ=/-Lf[.h �:�..� r� , I� F � t l' ✓ <br />, �--- CONTRACTOR__ <br />U FLAT <br />INS7AL ��A1�Rfip SERVIC�/ —___.__ / <br />I HENEBY APPLY FOR THE USE OF WA7ER <br />ORDINANCES AND POLICIES OF THE WA7ER <br />OR AS SAME MAY BE HEflEAFTER CHANGED. <br />A�ATENIAL9 <br />PIPE <br />CORPORATION <br />CURB COCK <br />SERVICE BOX <br />METER VALVE <br />METER No. <br />METER BOX <br />OT <br />_ PLA' <br />CONCRETE <br />" % ' <br />DATE INSTALLED: S"'_ <br />cooe I <br />IN ACCORDAi�CE WITH THE <br />DEPARTMENT N01Y E%ISTING <br />eicrueo: X__ <br />_ Si IN. I IN. I 2 IN. <br />CALV. - STEEL I�I �� I I <br />CI <br />TVPE: I {f <br />SMALL LARGE <br />� ON <br />._ � �J � OFF <br />L�BOR /�M1� EQUIP�N( RENTAL <br />SERVICE y� 9 LS `� <br />OP.DER„ <br />DATL'�/( ��.�� �:� �� 10�- <br />� � <br />W. O. <br />-_AD <br />�� � <br />r <br />_/__- ;..1_ �.__ .. <br />L _�PfiICE� <br />� , r�. II <br />SUB TOTAL <br />HOURS I RAT[ <br />[� <br />__� // I 1 I <br />I ------I II --_. -__ <br />--- <br />�n I -5 f ; �, !�3 : .. . <br />-- ___"'_"_ _`rc _ ___—___—__ i I. <br />___"_.__ y <br />--_�-- _-_._____-- __ '. _ �I I <br />_ ___ _ � —__ —__ <br />_ <br />i i <br />--`-� j --- ----- ; , : ,. �, : : . _ <br />--- -- -_ ----- _ --- ------'--- ,---- <br />� I ,i � <br />-- --- - -------- -- -- <br />- -. ----- -- - -----I - <br />� - ---i --- <br />1 _ � 70TAL � �7I I�L <br />REPAARKS_ L.G�[�-i1J'G__' . i!�! �� !`; G' , . )!.^ ',.� �� ��7� � <br />1. t .'_'_ _ ___' . �'%)/.:! i._ . <br />.__ -_-___' _. __._. .__- <br />-r . __-___.L'____ � . <br />!`.i i ..�� i � .J, !. ./ <br />_ _ - r---_ __ � � _ _ � J. <br />