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APPl Z '3S� _ APFiLICATION FOR SERVICE 1�1 o <br /> No. SERVICE�y� � O O� <br /> .�1��;»� CITY OF EVERETT WATER DEPT, ORDER <br /> ,� FIXED DATE� �1���19� <br /> � DEPOSIT S ��[.' ��" // <br /> s W.�O. <br /> �//� No. <br /> SERVICE (EYAODREgS �2S ��V�J ��l.� �l .Lf(. � �/ ' <br /> i ( <br /> > a.�� `l ' ��-�K•-� LOT��J�•�� ��1CL.1_'!�{I <br /> OWNER • v�e ����Gr /1 <br /> � � �� FLAT C�T�TRACTOR_ /U -�'.� <br /> INSTALI�����SERVICF � <br /> I HEREBY APpLY FOR THE USE OF WqTER IN ACCJRDANCE HIiH THE <br /> ORDINANCES ANU POLICIES OF TNE WATER DEPARTMENT NOW EXISiING � / , <br /> OR AS SAME MAY BE HEREAFiER CHANGED. <br /> 61GNlD:J( `L w' ��, <br /> MqTERIAL6 - <br /> PIPE L � ',: �N. f iN. � z � <br /> 4oPPER�- GALV.•-STEEL T I PRicE rMOUNr <br /> �C I__�— .SV� �I�/� .. <br /> CURBOCOCK N II <br /> �` <OT '. I I � 1I <br /> SERVICE BOX �pLASTIC - C I I��� <br /> - I � ���j . <br /> METER VAWE __—_— — --I _ <br /> METER No. TYPE:_ I 4f I _ <br /> METER BOX CONCRETE StdALL LARGE I —� <br /> / I— I <br /> _ �_ - � �I I /�� <br /> � - - I---L'��_ <br /> .- � - i---I- <br /> ��-� -I � <br /> DATEINSTAtLED: ❑ �N <br /> — ,S - . �' �"OFF � ��/ i SUB TOTAL �� � <br /> CODE � � <br /> IABOR AND EQUIPFlENT RENTAL <br /> — `�� � MOUR4 RATE <br /> L 9/ ! . <br /> ! -- �_L_ _ �; <br /> I J' C ! / � - ` I , <br /> ; - I i -�`- <br /> � ,.��� �: i ;. <br /> I __ - ---- -_�!-� <br /> D I - - - -�-- �; � <br /> REMARKS: j II , � � ' . TOTAL �� �I IC'7 <br /> y-f-� r.J .1 .J i> � � 1 /' !-_ (f � � i \ 'P U,o � tl F'!"_ <br /> r a�c�`��_L� . <br /> T l� • L) l <br /> -...__ -_�"--�-= --��'�'---'-=^--�-----�- <br />