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APPL. ��G��� APPLICATION FOR SER\'ICE SERVICEN� ]39 <br />No. ! ORDEH <br />% �r� CITY OF EVERETT WATER DEPT. L-�'7 7 !7 <br />�� /D DATE�G �..�.r71 O �Bf_i� <br />fJl FIXED <br />Yi� � � i <br />� DEPOSIT S ��J, � No�� — <br />/ i� <br />�� SERVIGEs rnoonces) ���� C'tZ"?EIG��� BLK. LOT sDD. <br />r )///I A �� <br />OWMER�_�`� ""-2-4i-` L�"*Lf� CONTRACTOR '`�`�""��� <br />i, ��� �� � <br />INS7Al.L�" �'METERED BERVICF <br />I HEFCdY APPLY FOR THE USE OF WRT�R IN ACCORDANCE WI7H THE �%_ 1� <br />ORDIA4kCE5 AN� POLICIES OF THE WATER OEPARTMENT NOW E%ISTING Jq1 �iitZ�%.�'�*,-�-f„�`�•+p� <br />OR AS iAME MA'! BC HEREAFTER CHANGEO. � Bicrveo: X_LL_(%�-- <br />MAT[FIALS 3i IN. I IN. I 2 IN. � � PPICE AMOUNT <br />PIPE �OPPERj-- GALV. •- STEEL �� � �I j _ . '� l � 1.�� <br />��� I <br />CORPORATION _ _ / <br />CURB COGK OT <br />� I � <br />SERV�CE. BOX PLASTIC - C I I I I <br />METER VALVE <br />METER No.�,y.iT��$7gC TYPE: I��� : I�{ ii -- —' <br />_�� <br />METER 80% CONCRETE SMALL LARGF I I <br />� ON <br />OAT[ INSTALLED: // _� S�_ - � �WFF <br />COOE I L�BOR ANO EQUIPMENT R[NTAL <br />REMARKS: /i�' �/ �� <br />/, �� K� <br />V ,-- --'otLr.4w,.t.e�� �-SL�'- <br />J <br />i, <br />/J SUB TOTAL �,.�j �(�; <br />1.l�-L-L <br />I HOPBS RATE <br />I � �I . <br />I I I. <br />I <br />I � � � �� � �f I % ;: <br />