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N'����. �,�� �. �� � . APPUCATION FOR SERVICE SERVICE N° � 3 Z R <br /> CITY OF EVERETT WATER DEPT. �RDER <br /> '�-TJ%GC DATE';�ac`s�-Y`_ ' 1 B''__ ' <br /> � DEPO3IT s..>. . _ is/j,✓J W.O. <br /> .. No._—.___--'_- '_ __" <br /> �p�,: t. '7 ���r . . _ �' � � . , �, . ,. �-. .. ._ _ <br /> BERVICE IeY AODREs���[.��Ii.�3X�_[!Yldf�-,cc,�_-- _______GLK.___.._LOT___AOp._ <br /> OWNER_ ��. � ! ' <br /> . r <br /> �___s.._�._ ic_-2Lr.�_i_______ -_ ___.-___CONTRACTOR!/.�.(,�,� /�w_,.� I�: t. <br /> .u�-_.:—_ <br /> . ,� -TtAT-�_ <br /> INSTAL� � __MEf"EREDSERVICE.--_.- ,'�"� <br /> _ —_--_._. __.__ __�__' __ _.'_ <br /> I HEREBY APPLY FOH THE USE OF W�7ER IN ACCORDANCE WITH iHE \ \ .. <br /> ORUIN�NCES AND POLICIES OF THE WA7EN DEPARTMENT VOW E%ISTII'G \ � / � <br /> OR AS S�ME MAY BE MENEAFTER CHANGED. e�aNeo: X V�� _..(��� _ . _ __ <br /> 1.1ATEPULB �i IN. I IN. '� 2 IN. I PRIC[ I-—AMOON—T <br /> P��'E _COPPER--GALV.--STEEL T I <br /> —__.___—_ ____. - ___ ..__ _ ___L—_ _ _ __ I <br /> __— — <br /> CORPORATION � ' I <br /> . __ _.___._ .________ ____. � <br /> GURB LOCK OT I I <br /> � —.___ —. �--_ II <br /> SERVICE BOX PLASTIC •- C I __________ I _—__— �I I— <br /> I_ <br /> METER VALVE <br /> -- _- . _ ___ ._ _. . ___ . <br /> -_ _ ..._— _-_. <br /> METERNo.�)��F rl�/�/�LfL��YPE �'��irJ I { I-_. _ ._ _--_ - . <br /> __ -_ __ _ i _— _.. . .. ___ —' _ — __' '_-' ( _ . __ _—_' J�I��-,._ <br /> METER BO1( CONCRETE SMALL LARGE <br /> J- !/�(:"�/ ;' ' ,> i •,;�/iCl ��. ;�c�i(�`'.%�D. /I�c� --- -- — J �L <br /> � -�-- � � <br /> �i r - %i.l�'� �/�.. , do. ���j_r,�1 --- I �---- �—=1`-�- <br /> ���j�.2L_�:�tt!� .'li > .�n/�vr J _--— -_� -�_ - -- � / - i�!; <br /> ------ � -------- I — — � <br /> �— - -- �I -- <br /> ON I <br /> . __—_— __- .--_—____. _._.. . __-.. ._.� — <br /> DATE INBTALLED: � � �� ,;�� � OFF � � � � SUB TOTAL ' / - <br /> 7CC �:, <br /> -- --- <br /> CODi � LABUR AYD EOUIPMENI"qCNTAL I HOURS IlATC . <br /> . . . ._--iII.1�� <br /> I_____-- ...._._ - __._._-_ _.._____' . _ ___.__"_- .. . I <br /> I <br /> _ ..._- __--_._ ____'"'._ <br /> / � <br /> " I ------...-.�.�-----�--_- ---� �� .___..._ <br /> --� - --�— ---------- ;- - -- —I I -— <br /> � -�- � - - --�--,—. - <br /> --- --�- ---- _._-_. _---� - - --- '" <br /> . _ .._.. . - -- . . . -- ---- � <br /> —_ � _ _ _ i_ _ .___i___.___ <br /> _ TOTAL �I II� ti I[''� <br /> �r , _— — <br /> REMARKS: �if lll�%A��` I1 �i i N��i'I,u � � (' ! ..� _ _ <br /> .. ... _ . .. _ .. . .. . _ . . <br /> �� /i �'J� ��'` - :.(� S . ____- _.- <br />