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r �I <br /> .� <br /> .�PPL � 3 a// � <br /> No. CITY OF EVERETT BERVICE � .. �� <br /> APPLICATION FOR WqTER SEflVICE oRDER NO. ,% ;rl.� ,: <br /> � FIXEp OL DATE .��_�gp� <br /> � �EP0017 s 7V' � <br /> _��J.._ .__ W. _ _ <br /> /� No.—_'_--.'—. <br /> BERVIC6 �er♦ �--/_ �� C��-/. .�__ <br /> - ---_B LK..__LOT___ADD._ <br /> OWNER—�--- ---�---L���__ CONTRACTOR_ _ <br /> 3 n . _ . —...__.___---- — <br /> INSTAL�;( ETEREp 9ERVICE___ . _ _ � <br /> I HEREBY APPLY fOR THE USE OF WATER IN ACCORD�NCE WITH 7NE ///� � <br /> ORDINAN[ES AND POLICIES OF INE WATER DEPAHTMENi NOW EXISTING '/ � � <br /> OR AS SAME MAY BE HEREAFTER CHANGED. XC'��� � L. _.�,�C��_ <br /> eiaNEo <br /> ATERIALB �4 IN. 1 IN. ! IN. I <br /> � y PR�C[ AMOUNT <br /> PIPE � AS �G____.- COPPER.. GALV.._STEEL_ 3� ��� � --I�.-.�. <br /> CURPORATION l S�U 5 f <br /> �__ --_—____—___ ) _ ' -"_ -' - i_ _ _ <br /> _!_ <br /> CURB COCK OT I i i— � — <br /> SERVICE BOK PLABTI .. C I ----- -- - <br /> -- —��-- --- � �— —�— <br /> METER VALYE - ---� <br /> _—_-_.__ _. . . I <br /> _ <br /> ME7ER No. �� ----- <br /> _. _ _-____— -__ __. _. <br /> _ TYPF.: y I <br /> -. . ___._ .__ . _—__ . . _. ._- � __. . _ . . -__-- _ <br /> METER BO% C�ONCRETE SMALL LARGE � , <br /> _ �y 'S�,•V�4 �fG1cLlQ W —,,--� �80-5� J --- --' -- -- <br /> __ -�-�—�`f — a _ _I_ —i I . <br /> �S D 7 3 __ - -- --- � I � <br /> ____ � <br /> _ --- ------ --- <br /> ---- --- _ I <br /> -------- — ---��-- - <br /> ------ -- - -- --- -- --�-- <br /> —i-- - — <br /> - --- ----- - --i-_ �-- ,--i- <br /> I �j^/!� ON <br /> OATE INSTALLE�: 3� ZS - � 5 "I OFF SUB TOTAL <br /> J <br /> COD[ I L�BON ANO EOUIPMENfRENT�L � MOUR! p�TE <br /> � _ _ .- - ----'SJeXI_3 [,4Ps _ .— <br /> ------ <br /> � - - - <br /> � --- _ -- L, c�� I 3 „ _ <br /> _ - - <br /> B � es - ��Irl � 3�' — -- --- <br /> - - -- -- <br /> � �-f,�3� �/ �l 35a� I3-�� <br /> — ---- — <br /> � _ � — <br /> — --------- <br /> � _ _ - --. _ . -- --- <br /> -- - <br /> —I ----- -- <br /> - — -- __ ___ ._ <br /> — TOTA L� <br /> REMARKS: <br /> � � <br /> � <br />