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A�PL.�� � <br /> no. � CITY OF EVERETT SERVICE <br /> APPIICATION FOR WATER SERVICF OnoeR NO. <br /> � FIXED DAT�'�`?� �/-__ .... _iG7� <br /> � DEPOAIT s e� C� w C / <br /> No. <br /> . _ . _/._. _. ___�'�__- <br /> BERVICE ����,/♦ooenn ��J�J/��/� )�"/�/y,'C�� _�'S. / L•�.� __ _ _ 9LK. .. _ _ l_o7pi 7. .�Q. "'-•"`�I.�?GR'12 <br /> OWNEN'�%7^' _� ./t�'�u�1� ('�.L� CONTRACTOR. .___ � <br /> J,� �� �/��7/ .__._ . _ . . .. __ __ . _— <br /> INSTALL�Y'_"AjETgqED SER��CE. . - _ . ._ . ____. _ '___'_�y�-_. . . . .___ <br /> I NERCBY APPLY FOR THE 115E OF WATER IN �CCORDANCE WITH TNE / ' ' <br /> ORUINANCES ANU POUCIES Of THE WATER DEPARTMfNT NOW FAISTING .U'�� � <br /> OR AS 5�4E M�Y BE HEHEAFTER CHANGED emHco: X r,�j,�,.f��;.cf. ._ . _.,,���,..� _ <br /> MATEPI�LB �. li IN. � IN. � Z IH. PRICE AMOUNT <br /> _��_ <br /> PIPE COPPER-� GAL.V �-STEEL I I I <br /> _-"_.. . . . _.__ . __ . . .. ._. I.__ --_'_{- . . ._-_ ._ <br /> CORPORATION I� , I <br /> ______-__ .. . _ ... . . _ . ___ _ ___ . .__ _ <br /> CURB COCK OT ' <br /> _ . . __.. _ _'__-"___ --_ — _ ___ '_._.. - __ <br /> BERVICE BOX_ . _ PLASTIC -� C I I <br /> _ . . _"_____ _. _'_ -__ .. . ._'-' <br /> ME7ER VALVE <br /> - ._..._ _—_.-_._ —_ '.. _ .. _ _ ..._ ._ <br /> METER No. . __.._._. . 1vPE: � I ___. ___ _ <br /> —_ —_ <br /> METER BO% CONCRETE SMALL LARGE � <br /> _--_ <br /> '______ ____ <br /> . _____-__ '- <br /> ____-____ . _. . � _�'_ <br /> . . � . __' ____ <br /> " ___'_ -__'___"- ._ '._-__'.—_ <br /> '— __' <br /> ____ __ '__-_ _'__— I <br /> ___ . _'__ ' '_ <br /> - — <br /> - __— ._'__ ' _ ._._.._ . -____�. _ ' __- . <br /> 1 � -- �- _ _- - <br /> -- -- ---- -- _ - - --' - <br /> - �� �9 � , oN <br /> DATEINSTALLED: <br /> �_l OFF SUB TOTAL <br /> COOC j L�BOR ANO EOUIPMENf XENTAL HDIiRS I p�TE <br /> -�I -- --� ^'`y� . . . . ��_- .. <br /> _._ _ . - "�'� / � <br /> __ __. <br /> __- <br /> --- - -._ _ . . __ . . . _. .�,� U 1-v_ . <br /> __- ---_ g.Sy�'�n� �+` /�.Q_ / - -- - - <br /> TOTAL <br /> REMARK>. <br />