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APPL.� V ! I � � APPLICATION FOR SERVICE SERVICE�Y� 'I � J S <br /> �h , ORD <br /> .��,�/.��� CITY OF EVERETT WATER DEPT. - . /..> / <br /> k �.� , , <br /> DATe.-�---------id��'� . <br /> � FIX¢D <br /> �' DEPQ8IT I i�J rt-� . W. O, <br /> f____ No.---_.--.. <br /> BERVICE ur�oonu�l-�d�� ���"t'.RlZ i a�� BLK. _�1�07�_,�ADc= --_- <br /> r, /; <br /> � /L G ti,% F� <br /> OWNF.R __--. - ---CONTRACTOR_�_7_y�_�._.<y—���. <br /> � / N �r <br /> INBTAL�ED BERVICE-------� ---------- ---- <br /> T-_ r� <br /> I HEREBI APPLY FOR THE USE OF WATER IN ACCOR011NCE WITH TME � � � �/� � <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING �/�� �1 � ,� �J <br /> OR AS SAME MAY BE HERE�FTER CHANGEQ. nar+co: X�i{(�f-�L.cZ-yJ-=�-`��----- -- <br /> MATERIAL9 I 1�' IN. I IN.� II �N. I PRIC[ AMOUNT <br /> PIPE _ COPPERi•-GALV.•-9TEEL ��� __ __•��7_ .'.b �� _ <br /> CORPORATION _�._ ___I'� ��L <br /> CURB COCK OT I_ �i __I_ <br /> SERVICE BOX PLABTIG -- C I � —�� I <br /> _--- _ _.'__' _ .--.—_ <br /> ME'fER VALVE f ,I_ _ __ _ I ___ _�� <br /> METER No. ----___-_. TYPE: ____-_.' _. - - _ -__-.' -- _ _ _-'_ _ � _3 F <br /> .-�1������x��_ .�x<.�'...1__I� --I-- --- - - �I�� <br /> ME7ER BO% CONCRETE �MAI�IT LAftGE I_� _ _ <br /> ---.1'cf�G_.:LtS:. -�.uF�FJ — I— — - ��- <br /> -- � � � — <br /> — ---- --I _ — -- _�— <br /> ----- --i — — —._L__. <br /> -- ---�-------�— —i— - �-- <br /> � ON <br /> DATE IN9TALLEU:/�` � � _ �� ,� QFF SUB TOTAL 9� (� <br /> �� ��� r� <br /> COO[ I L�BOR �ND EOUIPME`!T RENTAL I HOIIPY RATE <br /> � � � �l "� �v � , I . <br /> L�.S�_:..l�.Lt . .-.. -._.--____..—'__._- . ._-___.____.___-_-____. —. --}I-,,. <br /> —� ___ _-_�__ _-___--_-..'__ _.__-__--__-._ _��� '--_ <br /> - ^ I �: �/ .I , ' <br /> M�Tt��lf' -- ---- ------ I�--- --''-='= � — <br /> — -- ---:-_;"�i � <br /> ---- -------- ., <br /> �� � - � � �� � I � � � <br /> I ----------------- <br /> ------ — �--- S---- ----II -- <br /> _ '' � �._ <br /> �___ <br /> -- --- �------ --- ----�i <br /> ---------------. . __._.. � .�..--� -- � �-- -- �--- - _.- <br /> I - ._- I — (� / <br /> � <br /> /� TOTAL � ��,7 � Y' . <br /> REMARKS: ._ .__. _ _ _ _ ___. <br /> ._ . _ . - .. _ �.. . . .. _ <br /> _ , , <br /> �7��i. � n�7---} - .. ., �, r � , � . �. , . � ( . , . <br /> > � <br />