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� � �� � � <br /> �P SERVICE <br /> no. ,�� � CITY OF BVERETT 7 <br /> APPLICATIO��i FOR WATER SERVICE �RDER NO. . . �. <br /> � FIXED onTe_/��9 _1ef2 <br /> �v <br /> � DEPOSIT s Q'n W, p, <br /> No.—_ _ <br /> , � ) ; - c�i� S� <br /> SERVICEIav�uDn6ee) � ��L������a✓ � Cr��__LOT ADD. <br /> i <br /> OWNFR� ! �-�L7f(�I_�-�tv " _CON7RAGTUR _�_ <br /> i - <br /> INSTAL ��� � <br /> _METERED SERVIGE-___- -_. __ _ __ <br /> I HEREBY APPL FOF T!iE USE OF WATER IH ACCOROANCE WIiH TNE <br /> ORDINANCES AN� POI:CIES OF TF;E WATER DEPARTMENT NOW EXISTING <br /> _OR AS 5.1ME MAY 9E HEREAF7ER CNANGED. o: % ._ -L-��__--__ <br /> MATERIALS � IN. 1 IN-� 2 IN. � I _ PRICE �MOUNT <br /> PIPE ���5')"�'� COPPER•- GALV.•- STEEL /�� I � <br /> CORP� w� .T IN _.-_ I —}--__ . _ <br /> � _ sTit_TiTi. I � <br /> �C`RB COGK� OT W ItLL{�,4 -T�TE. � I —� <br /> SERVICE BOX __PLASTIC - C I I _I _ __ <br /> METER VALVE <br /> METER No. ____.`_ . _ 7YPE: _ _ __.... I.__��_I—_ I — — _-- <br /> METER BOX CONCRETE SMALL LARGE I <br /> -__ .. -_._.___ i_—� _ <br /> - '—i . i' I <br /> ---_'-._.". ---I— —I� I _— <br /> I I �I <br /> � ON <br /> DATE INSTALLED: l/ „J2� ��i' � UFF SUEt TOTAL <br /> •r <br /> CODE � LADOq AND EOl11PMENf RENTAL LMOURS RATE <br /> —� — � Q��--I '� — <br /> --—, —_���_ti x�.rc,+� I 3 -- — - <br /> �02 � � 13_ <br /> I <br /> —� ��"��'-T—��a--i j --- _ <br /> -� — ------ ---�-- - - <br /> i i <br /> TOTAL <br /> REMARKS: /� � _ "('.TS /: f�i:I:� ��_ r: ( �'r�rr ��� Tl��(' i7�^� � <br /> _ -_ - _-_ . . ___ . _t-_--_ -�r.,_ _ <br /> q rl.�r./�•} .: "� • ' .- - '- <br />