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APPL' � � O /��/ APPLICATION FOR SEP.•:'ICE SERVi(:E Nn Zq q � <br />No. . � <br />CITY AF EVERfTT WATER DEPT. ��ROER <br />, Q FIRED UATE_ _? _�_� . _...1� ���_ <br />� GEPq317 S �L ,__ _ �ti'. `-�. <br />- Na.__._ --__—_-. _. <br />/ .y i r� � / � ' <br />BERV10E�erfocneen-_(p.QIr�D. ./:�1.�_.yL�•.���,.t�j_-_ BLK.__1. _LOT �� _qOD_i'<rca��p:. <br />i , � . _. <br />OWNER_ � .�i-__"_��_1� °' ___.____.CUNTRACTOR___._ . iCr�rv •. <br />_.�_. _-. _.. _ _-. ' . <br />_.____.__ __'_'_ ___ <br />. , ., <br />F�aI <br />I IN97ALL� � METEREOSERVICE _. ____-__ <br />_.__ __- .. _ __ . ___ <br />i I HEREBY PPLY FOR THE USE OF WATER IN ACCORDANCE WITH 'HE i I ///111 �� � <br />� ORDINANCES AND POLICIES OF THE WATER UEPARiMENT NCW F.XIST:M1C �f /�� �� <br />OR AS SAME MAY BE HEREAFrER CHANGEO. eicH[o�% r - f '� <br />.__—. __. ..." __ IS��If: �r11ry,I11N.i 1 . . <br />_ MCOPPER GAW STEFL �� AMOb'T <br />.� . ..- . . '_ _ _ 'I__ <br />__ _ <br />PIpE . � I <br />� — <br />___ <br />' CORPORATION -"-"i -" -- - ... _.-.- <br />r_'_ . __ _ - _ _ _ . -. .' .'_' __. . . _ I__' _ . ... _ � __. .__ _ _. <br />C� URB COCK OT ; <br />.. _ - _ _ -__.._ —_-__ _-_ __. .. � <br />I _ <br />' SERVICE BO% � PL`�)._. C I ' <br />_.—_—_ . . _. _ _ __ _.--__._. _'_ <br />_" _'. I .... . <br />METER VALVE <br />r____— __ __. . . . _ _. <br />—_--__ . ___ . <br />METER No. TVPE: I'; I <br />�. _—_ _. . _. . ._._ . � I _._ _" <br />I --_ __' ._____ f <br />� METER BOX CONCRETE SMALL LARGE <br />�__ _._ .—_'__ -_ _ __ _--I'_—i .. <br />i_'_ __""._ _. - __ _' <br />"'__-_._ ___ _' <br />... ._. _-- _. _ <br />__ '_ I � <br />I _ __ <br />_ ___ _ _ <br />-'-_'—_ __' — .. .. _—. _ . .. <br />I-- _ _ _ I—_I � _�__ �- <br />__ -- <br />�-- - - - -- - - <br />� - , _ _ __ ___ <br />I i�" <br />OATE INSTALLEU: (j ' 7� �� I Ll pFF / SUD TOTAL <br />T x tc ✓ <br />C; oo� � _— L�B�=R ANO EOUIPMENf RENTAL HOURS R1TE <br />I _' _ _ _ ,C ��� r// ' 3 - <br />I _ _ __ <br />r -- - _ — -- y&o S�rl _ _ j <br />--- <br />--- — -, � . n q _ _ <br />i _ �-� %,�� �- --------- � 3 _ _ <br />� 1 - <br />�_ - __ <br />�__ _ _ _. _ <br />I— � <br />I _ TOInL � _ <br />I REhIARKS: � `' -� <br />. . � : i •� �: /,, . . � : � / ./� , . . . . . . <br />