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r; <br /> � .� �� <br /> � P'PP�"�/ A.APLICATION FOR SERVICE SERVICE o <br /> ' No. L � 4" ORDER N_ 2229 <br /> � CITy OF EVERETT WATER DEPT. <br /> � �'FIXED DATE��__�g� <br /> I � DEPOSIT s Z��t.l.� W.O,� <br /> No. <br /> � SERVICE (BY ADORese)�� / C— / C'�C�-�c� �;� C «��/'���"' <br /> !�"= BLK. LOT J ADD._/-_.�_�-�. 1_ <br /> I OWNER�Q/(f����L��llh'S ��it��� GONTRACTOR `l`` � <br /> I �NSTAL�FiET€RED SERVICF _ <br /> I I HEREBY AP LY FOR THE USE OF WATER IN ACCORORNCE WITH THE �1 � <br /> I ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> OR AS SAME MAY BE HEREAF)�ER CHANGED, slcNe : -1„�/ _f� <br /> � MAT]RIALS Y� IN.I� N. I I I PRICE AMOUNT <br /> � P�PE �OPPER�-GALV.-STEEL �� , I I <br /> I CORPORATION f I I ' <br /> I _I_ <br /> CURB COCK, OT � I <br /> � _ __ I� <br /> �SERVICE BOX� PLASTIC -• C I� ('�'�'f/� h"� � I 1 -- <br /> 1 _ <br /> � METER VALVE � <br /> � METER No. _�_._ TYPE: _ -_ I_ p' I _' --�— _ — — <br /> � METER BOX CONGRETE SMALL LARGE <br /> ' — _ _� I_ __ <br /> I I _�_ _' <br /> I � I <br /> � I <br /> � -___'— I � <br /> I I I I I <br /> I OATE INSTALLED: I � <br /> �-� f_ '7� � OFF SUB 70TAL <br /> I �ODE I LApOR AND EOUIPM[N f RENTI.L � HOURS RATE <br /> {�'�� <br /> i <br /> I—_�I I <br /> I `'17�—C` __I_�__ __— <br /> I___I /� .. / _" <br /> j_- ` >r-`'- I 3 - -- <br /> I � - ��C - -��// j .� <br /> i i �'.� �•S I I _ <br /> i i -�- - _� - <br /> ,- i <br /> -�---= i <br /> I � TOTAL <br /> � REMARKS: �/� — — — — <br /> � — � — <br /> 'C:ic ' <br />