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nrr�. / � ��� APPLICATION FOR SERVICE SERVIGE 2 6 J <br /> ORDER <br /> N�. /n CITY,CjF EVERETT WAjER DEPT. ( �� �S � <br /> /7`���� � /j DA `x —1 �. <br /> � FIXED , I /JA �P-�-L� �iCl'��-c i �. <br /> � DEP091T s /{JQ C�A — No�� — --- <br /> -� . <br /> 9ERVICE ier �onn�es�__ . �� ����J� -----BLK.___LOT.-__-ADD._ --- <br /> -.� _ y� .__-_'-�!/J�-. <br /> NER_--'—___ _ __"--'-__"---_CONTRACTOR_—_-_'_'—__—___"- -'_. <br /> . __.'--_'___.- <br /> -I�N-Ql� ��C� � FLAMSiE�D-SERVICE__._-- __...___------ <br /> INSiJ.Li_ .. ..___-_ -- .. ___ ---_ . . __ <br /> I HEPEBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE - / <br /> ORDIN�NCES AND PJLICIES OF THE WATER UEPARTMENT NOW E%ISTIN6 •J / �t� <br /> OR AS S�ME MAY BE HEPEAFTER CHANGED. fIGNEo:X�_-__"`"_�� ' <br /> MATERIALS 4.IN. 1 IN. R IN. PHICE AMOIINT <br /> PIPE __'__'COPPE�-GALV.-�STEEL ____ _'_IL_ _ __ _ J�i /1,.J� <br /> CORPORATION I' <br /> (CUpB COCK • ��T�__. .-_—_.__�_- _���_-_' _ —_ � <br /> SERVICE BO% 1 PLASTIG� -• C I � I �_ ��.. <br /> METER VALVE <br /> __—__..__. —_ _ _ _____ _--_ — __— ______ <br /> _._ <br /> METER No. TYPE: I„ �4 <br /> METER BOX � CONCRETE SMALL LARGE �� <br /> --- -- • }_-- �_ �-- -- - I l 33 <br /> -- `' � --� � j-L� <br /> � i <br /> -- �- l -- �- � <br /> - ---------- -�-� --i_ , -- �- <br /> ��'ON / , SUB TOTAL �� � <br /> DATE INSTALLED: I n OFF �� / I� <br /> � �'j- c. "1 <br /> CODC I LABOP ANO EOUIPMENT RENTAL HOUR9 RATE <br /> � � � ' �, � � � � <br /> � . ,, ; <br /> , . . . . - ------ - -- -�--- --=, - � <br /> � ------ --- -- --- ----— � <br /> _1 <br /> i lh.�. ,v(�— -- �---�-- -�' 1 I�---�`���-- <br /> --i � -- � — - — --I� � __ � <br /> � --------------� —__ ----��—!-- <br /> ----- — ------ <br /> ; _.'. <br /> _--- - - -- --- <br /> — -- - _ — _ T— <br /> �_ I __'-____ TOTAL ��/�h� <br /> REMARK3: �--'-"' � ' <br /> . _ . .. __. ._ ____ _.. ._ . . � . <br /> _-__-___�1....--- —_ ___ ._ - . . . __. . . . _ . _. __ _ <br /> � <br />