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APPL. /./ g / O - APPLICAI"ION FOR SERVICE SERVICE �° $ ? <br /> No. ORDER <br /> I g y�� n CITY OF EVERETT WATER DEPT. DATE ��«isE <br /> '�j FIXED � <br /> ❑ �� = <br /> oePos�T s �'•a• <br /> No. <br /> SERVICE 1Bv�o�Rcss1����. � � �`�� �W� /—.--OLK. LOT ADD. <br /> OWNER F�N r�� —Ilt.f—la�' �� CON7RACTOR— <br /> � FLAT <br /> INSTAL,3 y'"""�..�c�:..��" �cnWCt— .--. <br /> I HEREBY �PPLY FOR 7HE USE OF WATER IN ACCORDANCE WITH THE ,� J <br /> ORDINANCES AND POLICIES OF 7HE W�7ER DEPAR7MENT NOW E%ISTING ����� ��pf"' <br /> OR AS SAME MAV BE HEHEAFTER CNANGED, eicNeo: X _ —__ <br /> MATERIn�S I�/i IN. f IN. 2 IN, � I PpICE AMOUNT <br /> PIPE COPPEH�• GALV.••S7EEL � ,��i�� <br /> 4�___ / � <br /> CQRPORATION I i I� 31l� <br /> �CURB COCK� O i � <br /> `SERVICE BOX �LA571C�-- C I I I <br /> ME7ER VALVE <br /> METER No. TYPE: I ;f <br /> METER DOX CONCRETE SMALL LARGE I <br /> ��%1A`i80-531 / 3���0 <br /> � � <br /> � � <br /> � <br /> � � � <br /> � ON <br /> DATE :NS7ALLED: y_� y,r ,' ��ppF SUBTOTAL I �J � <br /> CObE �_ LABOR wND EQUIPMENT RENTAL I NGU0..1 RAT[ <br /> --..��.�� —___ I—�_ J I� '. <br /> � � —�� � <br /> -- I�_ _ I� -��'t c <br /> i ' h_.o«�— — — — <br /> � I '�� I <br /> �_�.�— _ ��% �I 3 �:��j <br /> � , <br /> �i . � ; ,'��� — -- — --- ��� —�I 1 `� - <br /> I I <br /> � TOTAL �� / � <br /> REMARKS: ��-� <br /> --_—__ — <br /> _—' <br /> — � <br /> —�-- <br />