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AP�I (� r( ,� APPLICA'i ION FOR SERVICE SERVICE ��° � H �� � <br /> No. <br /> J a�CITY OF EVERE'iT WATER DEPT. ORDER <br /> FIXED �� �Q'—� DATE���_iB� <br /> � DEPO5IT 5 �,Wj'o�' <br /> SERVICE (6Y ADORE56)� I 1 � ' Lfs�' t' e— F1 l� —BLK. LOT�2-�ADD!-'�CCaN W 0�� <br /> OWNER�1l`�'� CA �`��' r) CONTRAGTOR J A L'HP <br /> 11 LAT <br /> INSTALL3L�_ RED SERVICE - <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLIC�ES OF THE WATER DEPARTMENT NOW E%ISTING n y ! <br /> OR AS SAME MAY BE HEREAF7ER CHANGED. s�cneo:� SdA.LLSG'�—K-r�c���^'�' U <br /> fdATER1AL5 3i IN.� 1 IN. � 2 IN. I� Pp�C[ AMOUN'f <br /> PIPE COPPER•-GALV.--STEEL I <br /> i <br /> CORPORATION I Ii I <br /> CURB COCK OT I I I <br /> �ERVICE BOX• PLA571C •• C I I � I <br /> METER VALVE _ __ <br /> METER No. TYPE: I 3f <br /> ME7'ER BOX CONCRETE SMALL LARGE I <br /> I C� <br /> � I_ <br /> I <br /> —I _ <br /> I I I I <br /> q O'ON <br /> DATE INSTALLED: �-- /! ` 7� � OFF SUB TOTAL <br /> CO�E I LABORANO EQUIPMENTRENTAL � HOURS RATE <br /> � 1 � - �1_�_ �—`-� <br /> � Ww �r /tic-fr, /.ZS� o.� �� ��JC� � _ <br /> - u drr�/'ccc�id %6c� rr �2' /�if��(t• �� I`l _�i� � <br /> � — <br /> I 1 I ,) �I � <br /> I <br /> O ��d•. t.t Il,^a-h f --_ I I I <br /> . ____ —_. I �1 I - <br /> i _— —'__ I I� <br /> TOTAL � <br /> REMARKS: /+ <br /> —s-��1� -- <br /> �_�.!�__...—"_'____'__—"—__' —'-- - <br /> ... �,. _.. <br />