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, <br /> ��; APP��� � APPLICA710N FOR SERVICE SERVICE Na 21 q� <br /> � No. � CITY OF EVERETT WATER DEPT. ORDER <br /> ; �FIXED �1 - . . DATE�,/� ._18� <br /> � DEPO317 s �D` cl� � / <br /> � -�- W. O. <br /> ' (�/'PIi lC.c�JeCl �)� � No._ <br /> I SERVICE (6YADOPEBY)_-.�� �"' "�'"'��LK. LOT.�ADD!�'-'""=7J� <br /> I OWNE �CL������ GONTRACTOR .________ <br /> CF����7� <br /> � INSTAL�� �ME7ERED SERVICF <br /> i — — _— <br /> � I HEREBY APP Y FOR THE USE OF WATER IN ACCOROANCE WI7H THE �� <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING <br /> • � —__ <br /> � OR AS SAME MAY BE MEREAFTER CHANGED. s�cueo: X- <br /> � MATERiw18 I l�i IN. 1 IN. � 2 IN. � I � PRICE AMOUNi <br /> I�_PIPE COPPER-• GAIV.•-STEEL _ i I � I _ <br /> I CORPORATION <br /> I <br /> � CURB COCK OT I <br /> �— _I _ ___' <br /> � SERVICE BOX PLASTIG G I I <br /> � METER VALVE <br /> 4 METEr R No--- � TYPE: �-- I ?.{ _ __ --- — __ <br /> � METER 90X CONCRE7E SMALL LARGE <br /> I _.-- I —__ —. <br /> I <br /> � _I — _ — <br /> 1 —' I— __' _'J�_ _. _ <br /> I I I I ' <br /> �-ON <br /> I DATE INSTALLED: �_�?_ J� I � OFF SUB TOTAL <br /> C�I LABOq ANO EOUIPMENf 9ENTAL I HOUR5 RATE <br /> I I <br /> iI _____- "- . ___-__ �-��CI��SG/t -�, ����. _ - <br /> � � /ry `7 � ��L17�-F -'�-- - - - <br /> - -(}�---- <br /> _ �� ��� -�- -- <br /> ' ->,� / -- -- <br /> Ii- -- v !-- -------- �---- --- - - <br /> � i - -- i--- ------- <br /> I- � - <br /> I TOTAL <br /> I REMARKS: �//�— � � <br /> �'r'LiGf /i.LS ill� v PD'� /:«1�t/__.--���—�l'=���� _ _ —. <br /> _�s <br />