629 E CASINO RD 2016-01-01 MF Import

APPL�� APPLIC;AI'ION FOR SERVICE SERVICE N� 2380 NQ ORDER CITY OF EVERETT WATER DEPT. 1Z( �.4 ��FIXED p b4TE .. _I B 7_� n DEPO8IT s��L 4�� W.O. . _ .._______ No.__ - ..__-. ._ SERVICE �er eoonu�i-��<<.- `�- ---��-'��`-,��BLK. _._ ___LOT.1'L�_- .nDO. �-. -� OWNER�O�T• - �LI��R�.li _ __... CONTRACTOR __ _ . _ .___. --�-- LAT � INSTALL_j��--- EREO SERVICE. -� - �- ----- --- - � i I HEREBY �PPL FON THE USE OF WATER IN �CCOPDANCE WIiH THE OROINANCES .�ND POUCIES OF THE WATEH DEPARTMENT NOW E%ISTING �`'� _. ' OR AS SAME MAY BE HERE�FTEfl CHANGED. eicnEo: X � J MATERI�LB V� IH.' 1 IN ' Y IN• �I � PRICE AMOUNT ' PIPE GOPPE � GALV.•• STEEL �J I .. __`_ __ ' _— — _. _...__.__`- - . II ,, _.-. . :-.�... __ .. .-_- - _ . _ _ ' CORPORATION / . _____-_. -_I-_ ---- --- ____ ____ . _ _____ - _ _- � -_. . �I _ -_. � � . �UR-'CK OT � � ��__ ' , . - __'.- __' ' - ' __ —_- _ _ i- I SERVICE BO% PIA�-- C � . � . . . .__ ._' __ _ ' -. _ _- _ � METER VAWE � I _. -- - METER No. TVPE: I� w _ _____ _ � �._—____ . - I - ' � � METER BOX ':ONCRETE SMALL LARGE � ___ _ _ __._- -_ . __ i. _ __—I �—__. -___ . , i .._ . _ . _. - . '__i _ I —_ -_ ' _._ —._ 1_ _ __-_ __-_ _ ..__.. i__ __ _ '_�_ ___ _ __ _ . _ — � ___-_____. .__-_ _—i— '_. .. . _. ._ __. -__ . _. . . . ___ . . __. _-___. _ _ �_.__-_. __ _ ..__. '_. .._ ..__ . . _ . - _. '_.� __ _.. , � � ��7 ON I OATE INSTALLL'D:/ 'f •7% _ �/ I �4� OFF SUB TOTAL L / T � LADOR ANO EOUIPMENf RCNTAL I�UR4 R�TE COOE I � ---- -- �. � �9 " __ _ _ � i /-i' t�/'/�!� R _ � s� ;_ _, _T_ 1 L�1 � , „ , � - - ;--'� _ _ ��T' ' - - - , - - --__ _ _ _ e�U � _ _ -- ,-- - i— TOTAL � REMARKS: . .-. ..