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APPLICATION FOR SERVICE SERVICE j1�° 'I d. .', `v' <br /> AAPL. ���� � __] � ORDER � <br /> No. '� <br /> CITY OF EVERETT WATER DEPT. �/ <br /> �IXED DATE. __l _-.7__ ___18.�=� <br /> � � ' <br /> � DEPO5IT s �+C� _ �--�_' w. O._ _'- ___ <br /> /1� /1( ,�e;� -�t/� <br /> BERVIGE �eveDoncee�-lrS�_�__�f7_(_./L�i---�L! .---dLK.____—_LOT Z.L�_AOD.�S._T�Tf.s-- <br /> OWNEfl—YJl'j1��____�. �'_._(�IJ L L.E-�. _' -___CONTRACI'OR_/�?_�.�J S�Y/`� S�1 ..—_-- .__ <br /> � <br /> %� FLAT �O� O �7D YT <br /> INSTAL ,�—_AKiMlRD9ERVICE__ _ _ . ._._—_ _ _ . _—. ._..__ __— __-- _. -_ __ ._... -. _- __ ——_._ <br /> I HENEBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE � , ---/// /, <br /> ORDINANCES AND POLICIES OF THF. WATER DEPARTMENT NOW E%ISTING �S. � / if��,J� , �J_ <br /> OR �5 S�ME MAY BE HEREAFTER CHIINGED. eieHeo: % _ �N._. . � <br /> MrTCRIM1LB �,i Ifl.l 1 IN. I 2 �H. - I PPIC! AMOUNT <br /> 1�� <br /> PIPE COP�ER--GALV.•- STEEL L �� I_ _ I <br /> CORPORATION �� — '-"---- � I I I <br /> —_��__ _ --' <br /> CURB COCK OT � I I II I <br /> SERVICE BOX _ PLA9TIC -_C I _I __ I�_, <br /> METER VAWE � _ <br /> _ _____-__.. __. _._ -.___.—__.._—-_.__ _ ....._ __—. _ _---__— .. _ ._ _ <br /> METER No. TYPE: I 3f _. _.__ �—_ <br /> ____—_—_-___ __.. _ _ .._._— -- .—. . _ __. ..__ _ . . — <br /> METEft BOX CONCRETE SMALL LARGE __ _ I _ <br /> _ __ <br /> —'_'—__.--'.______— I I <br /> _ — . —— __'_---- I —I— _—____ i —_" <br /> ! I �I __ <br /> I — — — --- <br /> ' �—I <br /> — ------- ----- -- I------- - ---- �---- <br /> - ----- '_ , _ 1__ -- �--�--- <br /> __ —._____—_. —._—___ ON I.__�__I_—i�I=—__,-- <br /> � <br /> DATEINSTALLED: I � OFF SUB TOTAL <br /> COOE I LABOR AND EOUIf•IAENT RENT�L � NOURr RATE <br /> -- --- - - ---- �---- ----{; ,I— <br /> —---- -- ----- _ - <br /> --- - - --- ----- '----- ----, <br /> -------- � - - - — <br /> -- - - -- - ------ -�- - - -� ��- <br /> , <br /> -------------- ----- - -- -- - - - ---- -- <br /> ---i � _ <br /> -- ------- - -- . <br /> _ - - --- � <br /> __ _ _ _ ---� - -' - .. <br /> -- '-_ _ _ -- _ � <br /> __ � _� <br /> �� _ ___r. ___ TOTAL I' _— <br /> REMARKS: �^ � � � .. . _ .. <br /> � J �� �'_ __. _ ' _ . . . .. . - - _ <br />