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APPL. � ��� SERVIC'E <br /> No. ,� �:�/OL�O CITY OF EVERETT OROFR NO. <br /> APPLICl1TI0N FOR WATER SEFiVICE �� �/ � <br /> � FIXED OATE �/.' .r _. . iN�� <br /> � DE?OSIT s �:J �J .¢/ , Np��_ . . __._ . �J <br /> �/ /,� ,/ 7 ,` �Y�[�d <br /> �Z S� n,! ///f � <br /> 9ERVICE � �non[Be�- ��.•��. (./'� �"""�t���' oLK. l_//_ _LJT�G���AD�"�_u " _ <br /> � <br /> OWNEH -� fr q:f}J-t>L/ _ CONTRACTOR <br /> // � —. <br /> INSTALL7/ . _ .METEREI) SERVICE_ _ _ _ _ .__. ___ _. . _. _._______ . <br /> 1 NEREBY RPFLY FUF THE ❑SE OF W�7EN IN ACCORO�NfE WITN THE � <br /> ORDINANCES AND POLIQES OF '1M! WATER DEPARTMENT NOW EEISIING �' �._ <br /> OR AS SAME MAY BE HERE�FTEd CHANGEO. -- emaeo: % C� �i«<��_�C �__ _ <br /> __'_ <br /> M�T1.RI�LS 4i IN. 1 IN- 3 IN. I � PqICE ♦MOUNT <br /> P�E r�m1�� CUPPER -. GALV... STEEL _.. .. ._� �. �`. � <br /> •I�'+ . ___. '—_ <br /> CCRPORATION .N ��pD r . _ . . _ _ 'I_ � , . ; _. <br /> ___—. <br /> CURB COCK OT ' I � I <br /> _._—_ _.. ____ _' <br /> BER`i10E BOX PLASTIC �� C I _ '�,, ,` i __ <br /> METER VAWE � <br />�. I . —I � .. ___ <br /> METER No. TYPE�. I '� <br /> _'—_- I .. _ . ., _ <br /> METER PDX CONCRETE SMAIL LARGE ___� <br /> _.---_'__._ _ ... � <br /> � '_ <br />�------- - - - - � _- I � <br /> � -- ---- - <br /> i � <br /> -- - - � __' - -- -{- -- <br />- -- - --- - <br /> -�- -- <br />- ------- _ _ _ - _ i 1 �_ <br />-- -- - __ ._ _ . <br /> _- - - - <br /> , � ---- --- <br /> fy ON <br /> UATE INSTALLED�. � �/��� I � OFF SUB TOTAL <br /> ( <br /> COOC ', L�90N ANO fOUIPN[N! a[NT�L i0i1R5 111TC <br /> _:�, �BN.��ay 5 <br />_�_L6�LIN� _ S _ _ _ __ - ---- <br />�-- �z.°y ��/ -, � / _ ' -- -_ <br /> � 3'� ,{�� � S <br />--� _ 3 �l v " -- � - <br /> � <br />^ TOTAL � <br /> REMI,RKS: � - <br />