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AP"L. � Q�� / APPLICATION FOR SERVICE OR�V R E N� aG 3 H 6 <br /> N/�/'� / �-� � CITY OF EVERETT WATER DEP'i. onr . _---`�"7- -���`' <br /> � - - <br /> � FIXED � <br /> � DEPOSIT f �GC�_�'`_._ No. _--_____-_--_. <br /> �''�t����. <br /> SERVICE (e ��boacen__ � � �- -- ��� ----BLK.-�.- _LOT_ _�-OD�._-_ -.- <br /> OWNER-..�"�/-��!�``L�♦ '... _ _ .CONTRACTOR-_ _____ _.-__ '_ ___ <br /> .' A FLAT <br /> INSTALL_./�--MBFMiB SERVIC _ -__.__._ ----_.______.--_- —n _...-__ <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITN 1HE �J `/(�/1 !�l(//, <br /> ORDIN�NCES AND POLICIF.S OF THE W�TER DEPARTMEN7 NON' Ef(ISTIHG ei¢r+eo: X .._l�1_�6�� _A,[C_1L�_Sll���t�- - <br /> OR AS SAME MAY BE NERF.AFTER CHANGED. <br /> AIATERI�L9 Y� IN. 1 iN. i 2 IN. I I PI11LE AM T <br /> T- ___"-�� /_ir <br /> PIPE �GOPPE "'GALV.-- STEEL _ f__ ___'I______I__I '`� ' . <br /> � � <br /> CORPORATION ` — � - II—�— <br /> _ OURB COCK 'r'-97T -_- -__��. _._._- —I I _ _�L � ��/�_ <br /> --�y-_-_"___-__- I � <br /> SERVICE BO% P�ASTIC-)-• C I _ -_ - ���- <br /> - �_._�_.. _I ._. <br /> METER VALVE - �-- - <br /> __ _ ____- .___- . __ — - _ <br /> -_— <br /> ___._ .__ _ -- <br /> METER No. TYPE: __ __I. _ _- _---- I --- <br /> ___- ' _'__'_._" -._.. <br /> ___ ._ ._ . _'._ <br /> METER BOX CONCRETE SMALL LARGE _ _ __ _ __-__ - <br /> --- -- -- ---f----7 � - I - I- - �u,�_ <br /> ----------— , , c� I — - / � / ,. <br /> --- ----- ------ -�'- --� — __ - <br /> _ ._ I — -- - �- <br /> — -�-- --- — I <br /> --- ------- ----- - I <br /> — -- --- ----- -- — <br /> -- —- --- - -- -- --- � <br /> — ----- � I , I <br /> I ON <br /> �-� SUB TOTAL /�� � / <br /> DATE INSTALLE.D: J . . �OPF --__ _ <br /> LOOE � <br /> LAOOR �NO EOUIVMENT PCNTAL � HOUR[ RAiE <br /> .. --- --. , . � � � ��: <br /> � <br /> � <br /> � ----- <br /> / ----- - - -�-� <br /> - . _. _. -- - - �� <br /> ' - - ' -----�--------------- i i <br /> --I---- -------- �— - -�lii 1(. ; y ' <br /> :' -- i__ <br /> � � � - _ - --__-- � <br /> --- ' ` � -'---- -------- -- - i� �i <br /> -- —�----- ------ ---i- _ <br /> . <br /> _ ----- -�— <br /> - - ---I-- <br /> ' - - - - --- � <br /> --- -- - - <br /> - -- <br /> _ <br /> _ -- - -I _ <br /> � - <br /> - <br /> - -- ��/ <br /> = i-'___ _ ._ '- TOTAL II �7l I�_� <br /> _"_- `_" <br /> REMAIiKS: -- � � ' <br /> �' <br /> �(7 �,.(��, <br />