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NO���• - � BERVIC[ � (� ` I <br /> LT�Y OF EVERETT ORDER NO. • � �} �C <br /> APPLICATION FOR WATER SEFVICE �� / p� <br /> � RI%[D DATE�1-��--1YZ! <br /> v <br /> � DE�Of1T �� No�-- --- <br /> n /3-�y-S� <br /> 6lRVIC[ ��Y AD011[ �1 O~ /-- —BLK..—_-_LOT..---ACD. <br /> OWN[R-���a=�-�L��-"`-"'=--- .-'CONTRACTOR_--__- ._. _—__------ <br /> N F}.AF- __-.— <br /> INlTALL S� E�CI TERED 0 ___ . __- -----.--.__ -- -.. - <br /> I HEREBY �PPLY FOR TNE USE OF WATEN IN ACCORDANCE WITH THE - 3�yf� <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENi NOW EXISTING � �dL <br /> OR AS 511ME M�Y BE HEREI1FiER CM�NGED. nor+eo: X - - <br /> MAtlRI�L/ K IN. 1 IN. � ! IN. i PRIC[ •MOUN� <br /> r�pE COPPER-•GALV.•-STEEL <br /> CORPORATION � � -._. — <br /> CURB COCK OT I — <br /> O6RVICE BOX PLABTIC -• C 1 —_ I _ . <br /> METER VALVE -- ----- --- ---- <br /> METER No. (! I�21 _ __ .. _ TYPE: _ . _____.. . I_K — - —_ — - - —_ _. _- <br /> METER BOX GONCRETE SMALL LARGE _ ___ <br /> __--_.____ -- ----I — <br /> -.- __- _ .— I <br /> __I — — —__- <br /> I --__ . _— <br /> _ __- _ _ .--___.__.—.'i-__ I. . . _ _-_ ___—_ . <br /> --__. -_. _._ ___ '__-- � <br /> 'j' ON <br /> DATEINSTALLEO� LI_ Z 2 I � OFF SUB TOTAL <br /> _�^/ <br /> COC[ I LAlOR ANO WUIPM[Nf RENTAL MOl1Rs RA1E <br /> I ' <br /> C � N� r,-'s! E_rt.,+ .— - --_. --,�,a..rL_ ��._ . -- - - <br /> — — <br /> � ' _ _ _ - <br /> -- -- - ____ _ _ <br /> - - - --- I- - -- <br /> —�� � Sa_9/o 3 _ i- - — - - <br /> —, _ - -- — <br /> — - -- <br /> - __ --- - -------�--- <br /> � - -- -- <br /> -- ----- <br /> - - -- - _ — <br /> � I TOTAL <br /> REMARKB: �___� V_ � . _ ' - �'----"--`. <br />