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i <br />�;,�� <br />� �I� " C� 1�1��OF EVERETT ORDfiR� NO. ��' -j � <br />AP� 7J _ �� <br />No. ��"Y APPLICATION FOR WAT@R SERVICE pA7E/t?/ ' —�p� <br />� FI%ED � ��/ <br />� DEr061T s� �.C(:4�i <br />L� �' , <br />VICC (�T ODI1[/� <br />N. O. _ <br />Ilo. <br />i7- a 9- s <br />BLK.. LOT__—ADD.—.------ <br />6ER j - --- <br />� t i �—.-- — <br />CONTRACTOR- --- -- -- — <br />OWN[ -- <br />/A �f1Ai.____— —_—. <br />INeTALL�—FMETERED BERVICE. -- --- - <br />I HEREBY 11PPLY FOR THE USE OF WATER IN ALCORDANCE WIiN THE `� '�e�,,._ _.___ <br />.ioN[o:x �--- <br />ORDINANCES �ND POLICIES Of THE WATEp DEP�RTMEN7 N017 EKISTING ���"- � P^1eC AMOUNT <br />OR AS S�ME MAY BE HEpE�RER CHANGED. N iaiH —L— <br />MATFRI��� I <br />PIPE ...._COPPER .- GALV. - STEEL __ _ --I � — — <br />GORPORATION _ ..__------ _ — — <br />_�— <br />CURB COCK OT � <br />�-- - <br />SERVICE BOX .. .PLA9TIC_•__C.�__. -- <br />_ __ <br />METER VALVE _ _ . _. . - � � - I ` <br />TVPE: I .- <br />METER No. (� SJ_D __ _ ----- -� - <br />CONCRE7E SMALL LARGE I <br />METER BOX _ . - - - --- �I <br />� —.-. _._..__—_—.._ _ _ _._.I -_ <br />—_ I ryl ON <br />Yy <br />n �FF <br />DATE INSTALLED: ' �7 � S- 7 �� <br />f- <br />�I1BOR ANO EOUIPMENf PENIAL <br />Sl1B TOTAL <br />HO=�R! I RATE . . <br />cooc i _ _.._-- - - <br />_�I .. . _.. _. - � .__ .--. - <br />—I - � /fN�.)t✓i . _.___ _.—_ .. <br />(.�_ y � ° �Y- � <br />_ - � -� -- - <br />_ J � vy � <br />--� -� <br />,---- <br />---- - - - --- <br />- --- <br />_ <br />� - - <br />--- _ _ <br />- _ � <br />_ <br />TOTAL <br />REMARKS: <br />� "1 <br />