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A�P��':pC�/e�✓ CITY OF EVERETT S6RVICE � r• � <br /> Np.� ORDER NO. .� �i1 .� T <br /> Jj! / APPLICATION FOR WATER SERVICE c/� ,/ p <br /> QiIIX!'..' DATE�[J.IdF_""_-1 YU C� <br /> /� / <br /> � DErOs1T f�Q/� � �Wry�.O. <br /> �//J �, J/�� � OT.�/ 561f�' 7�'�Z�-'� <br /> SERVIG6 �w� o�[ul �/ L�"'�'~LQ11rE� "�—BLK._ LOT ADD. <br /> OWNE n — ' �=—CONTRACTOR / ��A���d.�n <br /> 02 " � <br /> INSTAL� METERED BERVIC - .- . -- -- -��-�� ----- -- <br /> I HEREBY APPLY FON THE IN ACCORDANCE WITH THE q • <br /> ONDINANCES I1ND POLIGES OF TNE WA7ER DEPARTMENT NOW E%ISTING ��///��,nl�?rLi� _ <br /> OR AS SAME M11Y BE HERE�F7EX CH�NGED. noHco: % ljfLd �S � <br /> MAT[111�L� 14 IN. 1 �N. � i IN. � P111C[ IIMOUNT <br /> PIPE COPPER•- GALV.--STEEL__ _ _ __ <br /> CORPORATION � � . <br /> CURB COCK OT I <br /> SERVICE BOX PLARTIC •• C I I , <br /> METER VALVE <br /> _METER No. L e4• �� —._ __—TYPE: . .___ ___ I �_ — _ _ _ -- _ <br /> METER BOX CONCRETE BMALL LARGE _ _ <br /> _-- —_ _. .— — I —l�l`—. _ <br /> I I <br /> --' --I I_ _—. <br /> _—I.__ I <br /> __—__ ' __ —_ I I_ '__ <br /> � ON <br /> DATE �N9TALLED: � L, � I � OFF I SUB TOTAL <br /> � � ,s�� <br /> COD[ � LAlOR �NDEOUIPMENfRENTGL I NOUR! P�tE <br /> - � l ) / <br /> � c C �Y>/i!���'.- - ------ --- _ _ ky�---I�_ ,. <br /> � r - -- <br /> - ----— -- --- -- — - — <br /> � � --- -- -- <br /> � - - � p � -�� ---- �---- --- ---- <br /> -� � ---- <br /> -- --- _ _ -- - - - - _ ---, - <br /> -� --- ---- - - - - -- -- <br /> _� _ -�---- <br /> TOTAL <br /> REMARKS: � <br /> �_ . . . . _. . . _. . ___. _ _— ____._ <br />