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� <br /> NOP , ��'j4 � r.I7V OF EVEHETT SERVICE <br /> 4VPUCATION FOR WATEF Si,RVICE OROEn NO. <br /> L� FIXED DATE _���Q. __ —JE/� . <br /> �,.OEPOSIT f _..)��•� W. O. <br /> _. . No.___ _ _ ..____ ._. . ._ <br /> �-� �� �Y1� .�� _I�.//1 /� •-v � �[ <br /> SERVICE fev Anon[���_ I �_.J� __ . �r_�tLK.. _._. _ _LOT_C-L� _AD�LQ�'1Z-�/�'M[Lc� <br /> � /! . _ '__ . __'_ <br /> OWNER�y.�_�CJJL_�%iC_ l�tC:n.�(E'::� . __._ <br /> - --._CONTRACT��R __ _.__ _ . <br /> � EUT - . ___. . _ . . . _ _' <br /> INSTALL_.`__�_�,METERED SERVICE'_. ___ _ _ ___ _ _ __ <br /> I HERE9Y APPLY FOR THE USE OF WATEP Ih ACCORDANCE WITN THE � <br /> OflDINANCES �ND POLICIES OF THE W�TER DfP�RTMfN� NOW EIIISTING �__ _/1 .�� -"�� <br /> ON AS £�ME MAY BE HEREAf1ER CH�NGE� Blcr�co: X .[�t%)(6� 1««< �� <br /> MATERI�LB V IN.I t IN. j t IN. �� <br /> I I L PMKE � AMOUNT <br /> PIPE /' � . . . COPPER .. GALV.�- STEEL .. .I y �"� I ; ; -� <br /> -�--�-. ��._.._ _ . . <br /> _ . .. _ . "'_I .,�_'__' ' <br /> . CORPORATION I� " - ( j� i��, I , . . �._� .. .— � ��-_ <br /> CURB COCK . . OT . . . _____ _ ___ _ ___i ___—_. . .I . __ .___ <br /> SERVICE BOX PL.ASTIC .. C I I <br /> ... _—_'_'_ _ <br /> METER VAWE �� �, '- � . - � <br /> ._ __"—_ . � .�.V ' �.�1 ' . . �._ / <br /> { —._— — <br /> METER No. i : � . TVPE�. • , , � ��- � ` i I <br /> METER BOX CONCRET6�j�� . SMALL� �ARGE I � � <br /> I <br /> � _�. __ , --- _ __ <br /> ; . --- <br /> , . . „_ ; � - -- <br /> _ ` __7 � ' ti � i1�', . .., , i �---- <br /> , I _ <br /> ____;;�_.�-%� ,t�;� �,_;-�_.i�_�_ � <br /> - _ — - -- - - --� -- - <br /> --- --- -- � - -- <br /> - -- -- --, - - - <br /> - -- <br /> _ . _ _ _ __ <br /> - - -- <br /> � , __�_ _ ___ <br /> I �, O N - <br /> DMF. INSTALLED: �/ '� , ` - . <br /> n OFF SUB TOTAL <br /> COOE L�BOR wNO E0111PMENf RENTI,L ' NOUR9 R�TE <br /> - _ -- - y-'��'------- I � -- <br /> _ < <br /> - -- -- - <br /> - �._�i��11_�,r/ � G <br /> --- -- <br /> I ��\��_7 � � 1 �/ � ` - - <br /> - __ _ __-- <br /> - <br /> —' ------ " —i�� s� ----. � <br /> -- - <br /> -�- --- -- _ t(�_�•,_�- , <br /> -- ' _ __-- - � <br /> TOTAL <br /> � REMARKS; ' <br />