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Na'�• � ��� � APPLICATION FOR SERVICE SEHVICF. Nn 2� 45 <br /> CITY OF EVERETT WATER DEFT. °ROER <br /> � FIXED DATE �/�� � <br /> n <br /> is �_ <br /> �DEPOSIT Sl�.���1 ���C 1 . . <br /> , _- . __ ___- W.O. <br /> No.___ <br /> �-� �.tI.J�'l. - �7' �Z�i� � <br /> _ <br /> 9ERVICE (er AODREea�_.__��rr ����/ �.�fs/NCJ �) .. BLK.__ _ LOT _. .ADU. <br /> / _ ._' .- " _" <br /> OWNER��-���_. l��j�•_�_ . C��„_ _. .___.___.. CON7RACTOR__ .. _ _. __._._. . .. <br /> INSTAL� C -"' FLAT .. . . - . - .. - . <br /> —_METERED SERVICE_.. __ <br /> I NENEBY APPLY FOH TNE USE OF WATER IN ACCOPO�NCE WlTrl 7HE 1/j J �"9 <br /> i, OROINANCES AND POLICIES UF THE WATER UEPANTMENT NOW E%IS71NG -�,N�/��/�/l,ff,�. / /f �� <br /> � OR AS SAME M�Y BE HEREAiTEH CHANGED. etcHco: // (�' / (. 7/K%,���� <br /> � <br /> MATERIALB <br /> � _- - - _-'_ 4 VL � I I�IN. � I PRICE AMOUNT <br /> _ .. _..... ..._�_�I.. __ . __-_. . <br /> ; COPPEp-- I i <br /> P�PE GALV.•.STEEL <br /> -.- _ ___ <br /> � — _ _- -� <br /> i CORPORATION - � ---- <br /> ._._ _.__— -_ - __- I <br /> �----_-_____ -- � _ . . ____--� __ - _--'-. <br /> CURB COCK OT I <br /> f —___.__ ._-_ ' _- __."_ _- <br /> --________ '_ <br /> I ._ ____'__ _'___ <br /> LSERVICE BOX �•LAS71C -- C I ' � <br /> -_____ .__ _- ___�. <br /> __' <br /> -._ _. <br /> ER VALVE � � � <br /> ______. <br /> .._ . . . __-- .— -'- -'_" � <br /> METER No. . . . � � .. � � ---- � -- <br /> TYPE: I � <br /> f_-__-_ .- . _____' __" __ __ <br /> � METER BOX CONCRETE SMALL LARGE ' � <br /> ' _ _. ____ _ -__ _. _".__ <br /> ___ <br /> — '__ —_- __ __ <br /> '______. . _.-._ ._ __I �' <br /> �- ____'-'_-_ __'-_ . __ . _. . ._. —. —. _ '_ <br /> I .-_'--_-_ _- '___' —__. <br /> ____ '_ <br /> i __ _-__ <br /> — - <br /> iI —_ _ -._' '_ __ <br /> -__. __ ___ ' ._ ' <br /> . . _. . . . ...- '_".. . ___ .'- <br /> , . _ __._. ._-... � <br /> I _" __ - <br /> 4 __ '_-_.. .__- '.____.' ' <br /> I .. _____. _ _.. ; ', . _ <br /> j _-..__ _ __" <br /> � I � ON <br /> I DATE INSTALLED: � � 3 ,� �-� OFF SUB TOTAL <br /> COD� L�BOp ANO EOl11PMENf PCNTAL HUUR9 R�T[ I <br /> �il � <br /> I._-_..._ _ . . _ �i � <br /> _ <br /> _ -. __..-__ <br /> � _ _ _ sf,f� At���frf� s���f-�s <<���.2r�r�;��N� - <br /> �_ /ViC�� — ��'c �i�_�i r�` � <br /> � _ _ .__ <br /> � ____ _ _ <br /> � _ _ _ v —1 — <br /> � - _ I <br /> I-- '� ��� TOTAL � <br /> I REMARKS: <br />