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1 <br /> � <br /> ; <br /> � <br /> �rr� �O�/_� APPLICATION FOR SERVICE acRliccN�, 16��� � <br /> No. ( <br /> � CI'i`Y QF EVERETT WATER DEP7. �RQO R °' _ <br /> � FlXED DA�N�C��1J.�:_Z. <br /> �IbEP081T ����� � �7 <br /> yy O. . W co <br /> No-cv n� X -_�— <br /> 36RMICE (or�oortta:�1�3�,�v Dau,a-y /(O� /C7' � Q � <br /> BLK LOT-l�DD.^�_`_ _ <br /> �!/i(�' J��� E1T0 �- <br /> � OWNER � _�CONTRACTOR � � <br /> I 11J�� S .. <br /> INSTAL�,_MET[RIED 813RVICF —_ _ _ <br /> I HEREBY APFLY FOR TNE USE OF WATER IN ACCORDANCE WITH �HE /1 +o� �// <br /> OROINANCES AND FOI.ICIES OF THE WATEP DlPARTMENT NOW EXITING •�� � I� � o////U, <br /> OR AS SAME MAY I]E HEREAFTER CHANGEU. eicN¢p: X. � C�^t—�i�' _ <br /> _ MAT[111AL� jG IN.� 1 IN. � 1. IN. I��L PPICE ��O�1NT <br /> I <br /> PIPE COPPER••GALV.-STEEL <br /> CORPORATION I '� � <br /> CUNB GOGK OT I <br /> SERVICE BtlX PLAl1TIC -- C 1 I <br /> METER VALVE _ _� _ <br /> _METER No.rj7�_!3�.�UO.rV-tiykPE:.I GT�K —_—_ _ -- _� ijD <br /> METER BOX CONCRETE 9MALL LARGE <br /> (�i ,�,Y/(� rCZi?;��i 7�� '� �?v�,� i1/���� <br /> d,�d!'.�= E'�7��2,�,�_ _�I1L��P�_7/111� -- <br /> �Zr.l.u� —.:Z�:-;t� � <br /> %-�in`�K.>P .:lc�c� -- - —I — — — y 3� <br /> J�=b�T�'j���42:d�1�/et� - I — -- - � <br /> 9 <br /> �3� � �` Gd.� ��? �� —i -- - �f9 9�>, <br /> /a � 3 ,C� x�1�Cc�lt..��� �.t'..� ,� —j � --� , <br /> /- �•8H -•7.,: K/ •:�c2U..szd�t'le -�o� " �,1� �— <br />� OATE INS LLE:.p�-�}��� ���'�� � �.��,�pp SUB TOTAL � ) <br /> �".r-�..`a�� <br /> CODF I� ` LABOR �I��O nOUiYMEN: REP�TAL I HOURS RI.TE <br /> I ._--_________—_ —_"____"_ _—_I — <br /> I <br /> I I <br /> �I� I <br /> � <br /> �_ � -.` _ � /��'l��l� � �rJ`'J�_'� _ <br /> � i. ] !. 70TAL <br /> REMARKS: <br />