Laserfiche WebLink
'�PP�-• �O� " � APPLICATION FOR SERVICE SERVICEy° 11 10 <br /> �No. <br /> ORDER it <br /> ��.f�,f� CITY OF EVERETT WATER DEPT. i: � <br /> �;�. �Q <br /> � FIXED DAT�" ` f __l9_'2/.. <br /> L'e! � <br /> � DEPOSIT s � D• —' W.O. <br /> y No. <br /> SERVICE (aY�CURE6s> ��'�?���— ��T �ZC-'L� ' <�f:' ` �`�� BLK. LOT ��1JeDD�/� yj -� ��L�'�� <br /> O?'VNER / _CONTRACTOR/���C/ �✓�+Y�.�� `--+� ' <br /> lNSTAL`"I�L/�FLAT —� <br /> ME�D SERVICE <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE ;I � I •� <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING I . y�a,y <br /> OR AS SAME MAY BE HEREAFTER CHANGED. s�cNeo: X_—�� � <br /> MATERIALS �i'� IN. 1 IN. � 2 IN.I I I PRICE AMOiNT <br /> F'�PE COPPER••GALV.--STEEL <br /> CORPORATION II I <br /> CURB GOCK OT I I I <br /> lSERVIC_�BOX (PLASTIC`-- C I � � � /1 }2� <br /> ' l—��— <br /> METER VALVE <br /> � METER No. __ TYPE: I }p <br /> METER BOX CONCRETE SMhLL LFRGE I <br /> -i _ -�I I <br /> i �i <br /> � - i <br /> --�_ _ <br /> � j--�--j- -- I <br /> Q%ON <br /> �ATE INSTALLED: OFF SUB TOTAL :� r� <br /> /i - 7 -l � ❑ C l ,-�� <br /> CODE I LABOR AND ECUIPAtENi RENTAL ' I HOURS RATE <br /> ��%�ry�.il/L� _��� �/� ��" � -" '(� <br /> I I I <br /> --� `�,_.. ,A O � i --,�� . <br /> i - - ---- � --i--�- <br /> � � �I �- <br /> � ii i <br /> � �, <br /> ��/ I I TOTA I ��.�3 <br /> REMARKS: �- I - � � <br /> i r�r J( � C � N 9 r�. O �)� �f �- • ' r C t.. „ -, �1 '� �� ,. <br /> '_'1 D�� ����' �_p'r__._'_—_—' —_.—___ __ " J' � <br />