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APPL. ')0 G8(�� APPLICATION �OR SERVIC6 esnvic�N� 163� <br /> No. oc o i <br /> CITY OF EVERETT WATER DEPT. ORDHI� <br /> � r�xio ,�,� � ., � <br /> DATE_!L�! Lb_�p�7� <br /> � D6�0lIT s O� � <br /> Vy.O. <br /> r� no <br /> �[RVIC[ (�y ADCI16�:q � 9 / �OVes � �l�cJ (/�— e�K.��or �oo.IL¢ �N <br /> OWN6R � lTW✓ A UI. i"(Oti10 �—_� <br /> CONTRACTOR <br /> IN9TAL 3L�_'LAT � _ <br /> � <br /> I HEREBY APPLY FOR THE US[ OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLIC�ES OF THE WATER D[PARTNENi NOW E%ISTING `�� 7 <br /> OR AS SAME MAY BE H[REAFfER CHANGED, aicNeo: X 'A niC' --Y7.0 Q �l/ �,. ' (r17/�y _ <br /> MAT[111AL� Si IN. I IN. 3 IN. �� <br /> � PR�CE AMOUNT <br /> P�PE COPPER- GALV.-STEEL -- <br /> CORPORATION <br /> CURB COCK OT I — <br /> 3ERVICE YOX PLASTIC -- p I <br /> M6TER VALVB ' . <br /> _M[TER NO. TYPE: � — <br /> METER BOX CONCR[TE SMALL LARGE — <br /> I <br /> � <br /> I <br /> I <br /> I I <br /> - I � ON <br /> DATE INSTALLED: � OFF / � SUB TOTAL <br /> � <br /> �, . <br /> CODE j LABOR AND EOUIPMENfRENTAL <br /> I� HOURS qATC <br /> �-�P7------- _ I_�- -- -- <br /> --�_ ��-- - ��- -- <br /> _ � --�-� �- _- � - <br /> _�- <br /> TOTAL <br /> REMARKS: _ <br />