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'P���iT�� APPLICATI6N FOR SERVICE SERVICE No � 789 <br /> '• L �.1 �t L ORDER <br /> / CITY OF EVERETT WATER DEPT. 1 <br /> _ IXED /nO f DATE��1.._���19�� <br /> 7� " <br /> � DEPOSIT q .�l� W. O. <br /> No._ .--_-- <br /> ISERVICE (eYAonRE86)�LO� ` v�``�\�I l��_�`���BLK. LOT_��ADD��C�N�IY� <br /> I OWNER�/Nv�� G• ��N �J�_CONTRACTOR_��1..1����_����_ � <br /> � 3/ h FLAT <br /> j INSTAL�11�1'�}@!p SERVICE L_ _. <br /> � I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE � <br /> OROINANCES AND POLICIES OF THE WATER DEPARLNENT NOW EXISiIN� ���t�!�� � � <br /> I OR AS SAME MAY BE HEREAFTER CHANGED. sicNEo: X ._ ��' `�' .fY�'`��___ <br /> � MATERIALS �i ItL I 1 IN. � 2 IN. � I PRICE AAIOUNT <br /> � PIPE GOPPER-•GALV.-•STEEL I <br /> � _T <br /> � CORPORATION I � <br /> , CURB COCK OT I <br /> � SERVICE BOX� PI.ASTIC -- � I <br /> � METER VALVE <br /> r_— __— _ _ ——— __ __— __ <br /> METER No. 7YPE: I i5 <br /> �—. — __ — _ <br /> I METER BOX CONCRETE SMALL LARGE <br /> I I —I _ <br /> �— I �— — <br /> I _I <br /> � I � ' <br /> � I �I I I � <br /> � ON <br /> I OATE INSTALLED:� l � _ �� � OFF � SUB TOTAL <br /> �.._[.. <br /> CO�E � LAOOR AND EOWPMEN'(RENTAL I ry0UR5 RATE <br /> �I t.L..hG —_.._—_—I—_/ <br /> I � �- � <br /> i � I -- -- <br /> I � <br /> � ' � <br /> � i — ---- I--- — — <br /> �- �/ - - ---- -- i - <br /> ,_ � <br /> I TOTAL <br /> I REMARKS: � <br /> i — /��� ��' "�' — _ <br /> _ n . �- 7/--rd.�--___—_—_'_ <br /> y _� v <br />