Laserfiche WebLink
2 0 82 ,s� o <br /> .' �9 APPLICA710N FOR SEBVICE SERVIC�T• 157ti <br /> N PL. /J v (J �S OR�ER <br /> � CITY OF �VERETT WATER QEP7. <br /> DATEL��� —187� <br /> •� d FlXED <br /> � DEPOBIT s /7�- rya�' <br /> fp1 � p P� �� <br /> 9lRVICE (sY ADDnuq � " /o �A L�� BLK._ '��LOT AOD._Y�a����L_ <br /> OWNER '� ��Y� c�r �!/��''�T CONTI?ACTOR..�+�cRJ�/Z0� L�/�SE <br /> � �i � <br /> INSTAL�MET[RkD BERVIC� --- <br /> I HEREBY IIPPLY FOR THE USE OF WATEN IN ACCORDANCE WITH THE � � <br /> ORDINANCES AND �OLICIFS OF THE WATER DLPIIRTMENT NOW E%ISTING �a�� <br /> OR AS S�ME MAY BE H[REAFTER CHIINGEO. elcNeo:X� v� -- <br /> MAT[IIUU fi IN. f IH. � 2 IN. I PRICE AMOUNT <br /> p�pE COPPE GALV.--STEEL � _{�_/i _ <br /> CORPORATION � <br /> CURB GOCK OT I _ <br /> SERVIGE YOX PLABTIf: •• C 1 I <br /> METER VALVE I __ .—_ —C-'! -4�' - <br /> METER No. �� O�� . TYPE: I,GpyL..d � — _ —�J� J� <br /> METER BOX QNCRET �� BMALL LARGE _ __ __ _ _ <br /> __ _t--i{�.W.%-i�[t—�l.E� ��Qd�__ _ � <br /> / / ,I _.. _ <br /> � <br /> __ _ <br /> � <br /> - _I — -- <br /> _ _ � � I—,—i � -- — <br /> � ON <br /> DATE INSTALLCD: //_ /,� r7/ I �OFF SUB TOTAL ���' � <br /> CO�E , J LRBOPANOEOUIPMENTPENTAL I NOURS NAT[ <br /> � �6�r I � sz <br /> -- -- - ---�,� _� -�, i-�- --- <br /> -- I'---- - - ��.� �_.,����- - - -- - <br /> -_ - -- --- - - -�- - - - - <br /> � 2 <br /> TOTAL �TZ OS <br /> _ REMARKS:___-�`E' �,/'� _____ __ _ ___ <br /> CJ � . <br />! <br /> � <br /> • <br /> � <br />