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NoP`� a�oac CITY OF EVERETT ORDERE PJO. Li I JS �i <br /> APPLICATION FOR �VATER SERVICE m� <br /> o�T�y�1G-_.�_—ta�� <br /> � FIXED <br /> Doj <br /> � DEPOSIT s� �,Wj'a�' <br /> �..:� �a� BLK.'__LOT ADD.— <br /> SERVICE (eYA�RE88)�Qa1�_ - '-- <br /> OWNER�Y��� G� —CONTRACTOR — <br /> '( . <br /> INSTALL �.�/� �1EE TERED SERV:CE - <br /> I HEREBY APPLY FOR TNE USE O��TER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WA7ER O=PARTMEN7 NOW E%ISTING .—�--�\ti <br /> OR AS SAME MAY BE HEREAF7ER CHANGED. s�cNen: X — — <br /> IAATf.R1AL5 �'i IN. I IN. I 2 IN. I � PHICE AMOUNT <br /> PIPE COPPER•-GALV.••STEEL � <br /> CORPORATION _ I � . <br /> CURB COCK OT I <br /> SERVICE BOX PLASTIC -- C 1 I <br /> METER VALVE <br /> METER No._'�J Nic� TYPE: _______I !4 _ __ --- � <br /> METER BOX CONCRETE SMALL LARGE <br /> _—.— —_ —._I—_�_ — — <br /> � <br /> --- _� _— <br /> . . � I � I —" '— <br /> ON <br /> DATE INSTALLED: ��it��'� OFF FUB TOTA! <br /> COOE � LAOOR AND EQUIPMEN'fRENTAL r� I HOURS RATE I <br /> � --- ��:``���� — <br /> I <br /> � �� �--- �-- - - <br /> . <br /> ', �%j �-= i <br /> - -, <br /> � - ---- ---�- <br /> i <br /> TOTAL <br /> REMARKS: � � _ L�i�'E���'G ' <br />