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APP�' / • / / � APPLICATION FOR SERVICE 5[RVICE N° �3 O <br /> No.• <br /> �r;��/i� CITY OF EVERETT WATER DEPT. ORDER <br /> � FIXED DATE.I� _.�7__._. _._IB�9'L <br /> � ,f�% <br /> � iJEP081T s �� ... � 1 <br /> W. O. <br /> � ' / � No. -_ '_- __ <br /> SSERViCE �av eooncoe� ?��'/ �" , t rf �.t.�rc-rc� `.��1�',a 1 , i! , <br /> !� , <br /> -'.. i � <br /> �.---- ___.-__9LK.- L T J•� pp(��GGIi� � �.. <br /> �' �'- p � <br /> OWNER- ��� f ��� , <br /> �-__..__ . _ _ ._.____ __.___-_ _ __CONTRACTO ' i____ ___ <br /> . '7��� '� FLA7 __-_ <br /> �NBTALL_____MG7{.pep 6ERVICE_ ._ � <br /> ___ _-_.-_ _ _ __-- ' <br /> - -' _ __-____' <br /> I HEREBY APPIY FOR THE USE OF WATER IN ACCOND�NCE WITH THE ' <br /> ORDINIINCES AND POLICIES OF THE WATER DFPARTMENT NOW E%ISTING <br /> OR AS SAME MAY BE HEREAFTER C�IANGEO. siariEo:X_. ����_____. _ <br /> .._ .._ . ___-.. .__ <br /> M�TERI�LB 1i1N. � IN. ! IIIN. PRICE �MOUNT <br /> ..PIPE ___'___ COPPER_- GALV_"'STEEL ._. .._ __'�I�I � I <br /> CORPORATION_______._-_ -__-______� __I__ �- _--JL_-_I_ <br /> CURB COCK OT _ I <br /> SERVICE BOR __PLA871C •_C I___ _ I I � <br /> METER VAWE - <br /> _'__-__-____.__.__ --__._-� _ _ - I- ___- <br /> METER No. TVPE� <br /> _ _-_ <br /> +S <br /> ____ .__'.--__.____-__..-._--_'_ _ _'__ '_.I. - ' <br /> METER BO% _ CONCRETE __ 8!fALL LAF.C:E I � <br /> -_-_ - ____ ....- ____ i � I_- _-_ I-. <br /> .. '___ _ __ _- ___ 'i�'__I_ <br /> ^ " � - - �. � <br /> __-_-___ ."-_-__'. -__. _ . _'___- . . _.._II - _-__- _�_ _� <br /> _ I I � I I I � <br /> � nN <br /> DATEINSTALLED� n OFF SUB TOTAL I <br /> COD! � LABOq AND¢OUIYMEN(PENTAL HOIlp9 R�TE � <br /> ____-- __"_-._.-______'... _.."_ . _"___"_ � - <br /> -._ ..._"_'_""- . _ _"_-_______'_' <br /> I___ - - __I-_- ___-" i I__ <br /> I --- '_I___ -___.II ________" <br /> __�I - ' _._. _ � <br /> . . __ ___,__ i_.____��-_ -_ "'_-_. _-_ <br /> _� '__ __�_ il � <br /> I I I - <br /> _____ __-__ ._ ____-_'_. <br /> '_-___"_ _ .. -_. <br /> . .- .__"- _ ' <br /> -_�__ <br /> � � _ . . - - . I �I I <br /> i . _. _ . _.. . __. . _ . . . _ . _.. _� .. _ � <br /> / TOTAL � <br /> REMARKg: .�C.1':''l.CB �C13tC11] �'C] by ill�].i16P -�- <br /> '_ _ ' . _ _._ __- ___._._.__._'__.-_ __. .._ _ ._ _ /- <br /> __' . _ __ ... . _ <br /> �� _ _ <br /> ..1�:_ .. f��� %� � .._ . . _ <br />