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tl <br />NpPL �� �<?� CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />� FIXED <br />� DEPOSIT � <br />� ^ � �L`A Y <br />SERVICE(BYADDPE66)- ��n/� �✓P�1IF�I a/�'�� / BLK._ LO7 <br />OWNER_ 1 qj`j(t�[� ��P✓P1�alry�p/�/ +(pt�,�]�CONTRACTOR <br />/ <br />INSTAL II METERED SERVICE "'�_L�P rP/�/�ci p <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WI7H THE ��� <br />ORDINANCES AND PGLICIES OF THE WA7ER DEPARiMENT NOW EXISTING <br />OR AS SAME MAY BE HEHEAFTER CHANGEU. eicr�eo:� <br />MATEHIALS � ii IN. � 1 IN. I 2 IN. I I <br />PIPE <br />CORPORATION <br />GURB COCK <br />SERVICE BOX� <br />METER VALVE <br />METER NO. � <br />METER 60� <br />COPPER -- GALV. •- STEEL <br />OT <br />PLASTIC -- C I <br />CONCRETE <br />DATEINSTALLED: <br />cooe <br />TYPE: � 55 <br />SMALL LARGE <br />I � ON <br />OFF <br />AND EOUIPMENTRENTAL <br />SERVICE <br />ORDER N° 5 4 9 3 <br />DATE__�f.' I�_�g��7 <br />T — � <br />W. O. <br />SUB TOTAL <br />� I <br />� �ti � � �? �G_-7 -- --- I - <br />i -- i <br />RATE <br />Torn� <br />REMARKS: <br />/MOUNT <br />