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I <br />� APPL���B APPLiCAT16N FOR SERVICE SERVICE Nn z p � � <br />N�. CITY OF [VERETT WATER DEPT. �RDER �� _ <br />Y� FI%ED <br />DATE—___�_'_' —'iB7S <br />� � DEP081T�. ___ W.O. I/ _ ._._—._ <br />S No._ —.____-._ <br />� SERVICEUrwnonnn �D//--_--^�_2N--��`�_—BLN.��_LOT��Y�ADD.vD _�r'�— <br />; OWNER�W�� N�_ `�'^_�_! —__.___—.CONTRACTOR-(,�Ji1� —_ .._—__.---__ <br />�' INSTALL�N FLAMiiGRlC'SERVtCE---._ _ --. —__ -- <br />I I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE �� �{% ) r��� <br />I ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING �g(y � <br />� OR AS SI1ME MAY BE HEREAFtEN CH�NGED. sicNco: %' � <br />i <br />M6TEPIAL! I�i IN. I 1 IN. I II IN. I � 1. I PRICE II AMDUNT <br />PIPE <br />CORPORATION <br />CURB COCK <br />BERVICE BO% <br />METER VALVE <br />METER No. <br />METER BO% <br />COPPER -- GALV. -• STEEL <br />OT <br />--PLASTIC_�__, ___ <br />_._____.—'-_ ____ .__—__ .__ ______._ <br />TVPE: I ff <br />CONCRETE aMALL LARGE <br />�_ _ <br />l.i��L3fC' —"'/O l'Qf /i <br />—� n s i�a a f �I a. r n_�r. n �` �. <br />.___ _ -��___ _ . _ __....__— _ __ <br />'! <i � r— .f _—__! . _' ��. _ /_'_,__ <br />� ON <br />DATE INSTALLED: L�� 7 Q'.� S �FF <br />J ol o <br />COD! I L�BOR ANO EOUIPMENf RENT�L <br />� ' <br />SUB 70TAL <br />MOUN9 ' PA'E <br />i--I _ . _ . " . _"�._' _ _ _--r' I _ _ _ <br />I I " _- - ' _ _ - _ . _ _- _- <br />-.._ _..-_-_ <br />i -, � � _ -�Q���--' y _ -- <br />i ; --- -- 0 � _ _ --�� �.� ----- -!� --- -- <br />I TOTAL � � <br />IREMARKS: {�1�1_ _J_al-_�...__/t /L-�__LV..L�_T'_d. 3-Yv � c�[ S' O' ___ <br />____ <br />�'— • <br />FW � ✓ e /�,0 � 6 5 �y � ! . -e l . _'� / l <br />