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- :-:. <br /> � No?�f 4�"J�� AP.PLICAtION FOR SERVICE serxvice Nn ZZZg <br /> � �� CITY dF EVERETT WATER DEPT. oRoeR <br /> 'I ��FIXED DATE����_i9.�, <br /> { ❑ DEPOSIT S .�,�,�� No�• _ <br /> �//� ! . ,.--, I -� 't.�t�-'�''�``� <br /> � SERVICE (ev wnoReea)_a_LLLC�_�f�.�� B�K. LOT��DD_���___ <br /> � OWNERc ��yj�)!�L� �yJ�T _CONTRACTOR_ <br /> � � AT — — <br /> I INSTAL �ED SERVIC�_ , __�___ <br /> I I HENEBY A�THE USE OF WATER IF ACCORDANCE WITH THE � 'u'�% <br /> I ORDINANCES AND POLICIES OF THE WATER UEPARTMENT NOW E%ISTING <br /> OR AS SAME MAY BE HEREAF7ER CHANGEU. slcNeo� . <br /> I __—___ <br /> � MRTEPIAL9 }� �N 11N. � . I I PRICE AMOUNT <br /> � P�PE �PPJE�F'J-GALV.-•57EEL <- J I I _ <br /> _i_ _J_ <br /> �I--C—ORPOR�ATION � <br /> CUR� 6 C�C OT 1 I <br /> SERVICE BOX� PLASTIC -�G 1 I <br /> � METER VALVE <br /> �_—_---_ _ _—_— --_— <br /> ( METER No. TYPE: I tp _ <br /> � METER BOX CONCRETE SMALL LARGE <br /> I _— - -- —_—I I__ — <br /> I�— _ _ - <br /> I � <br /> I _I __ —' —'_ <br /> I <br /> ' _I_ _ _ _ <br /> I I I I I <br /> � ON <br /> I DA7E INSTALLED: '�, �. a . �/] � OFF SUB TOTAL <br /> v <br /> � COOE I LABDR AND EpUIPMEN f RENTAL HOURS RATE <br /> i I _ ._ __ �_ —_—I_ —_— —.—__ <br /> t __�< < I� <br /> � ----� �;- � -�--� --- <br /> I � Y�[2_Ct'\ <br /> I /'y / I <br /> iI —vJ / -�" �'/� I� _ — <br /> � -�'_ -L�--- I L- <br /> I- � - ----- -- -- - i - ---- -- <br /> � TOTAL <br /> � REMARY.S: <br /> I --__---- _ __.—_.__ ._.__— _____________.__.— <br /> _+c_ -. <br /> - SLZ ��i!!� <br />