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� <br />' APPL. _1 � �u J � ' <br />No. •- CITY OF EVERETT s� `+'�" N� � 5 � O <br />APPLICATION FOR WATER SC-RVICE ORDER <br />❑FIXED <br />�a. DATE'_' I^' v � —18 9'�' <br />� o�Posirs 7S� _ I� f�Sl�liU__.__.___-�_ No.____ <br />/�'� / 2-7 z w. o. <br />SERVICE (pY AD�pEBY7 ���� � L-{(�jj [+�_ ,J� J <br />? '�/� �—BLK.___LOT ADD.�_ <br />OWNER �!�5,� %� �rL�� __CONTRACTOR <br />INSTALL � � F�-AT � ----_ <br />—�METERED SERVICE-1-_ ._ _ _ .____ <br />I HEREBY APPLY FOR THE USE OF WATER :N ACCOR�ANCE WITH THF. /� / 1,� <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING �/� /,_ -�� i/,/` ��-� ��-�1�� — <br />OR AS SAME MA} BE HEREAFTER CHANGED. eicneo:9C-'� ����_��� �� <br />MATER�ALS I� IN. 1 IN.'i 2 IH. <br />'7�/7 i+ � ' PNiCE �I AMOIINT <br />�'�P� }(7�/� � y� COPPER -- G 4LV. -- STEEL�'f -1 �J iTi I :I�T� <br />__'__-' 1�- <br />CORPORATION �����, � � L� "7 -- <br />J <br />CURB COCK OT <br />SERYICE BOX pLASTIC -- C I <br />— __-- - __ <br />METER VALVE � <br />--__._. _.-. ___.-____ __.._ __._. <br />/ (' _— <br />METERNo.UOO�UG'r TVPE: I .� <br />__. __.. ._ ___ __ ' <br />n ___ __ <br />METER BO�� CONCRETE-y��.S �SMALL LARGE <br />� .___ __._-_-_'_- <br />—�����1;c�, �' y0 / 7 v y_ i <br />DATE INSTALLED: <br />CODE i <br />� ( ) � / l/ <br />LA00q AND <br />—�•-�_�� �'- <br />z> > 7 <br />'_�_�C�-�� -. ----- - <br />REMARKS: <br />� ON <br />j OFF <br />f RENTAL <br />_� r <br />SUB TOTAL <br />HOl1R5 � RATE <br />__I___—� <br />--_ NO .4r]lUN � <br />___--_.,._ --�-- <br />pV1[f�c _t�l�e�or�-ssW1�e— -- <br />AnpllCations �;itl�ruf � � I <br />T�TAL <br />