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A���:Z, �: �G� <br /> ��, ._' . j�c � CITI' nF EVERETI ORDERE NO. <br /> APPLIC,=�IIUV t"OR WATER SERVICt_ / <br /> � FIXED DATE�.,[�__._19�� <br /> 0 <br /> � �EPOSIT S G�.j rl n� No�_. _____ <br /> � / <br /> �� � �' <br /> SE'?VIGE (e �oDRe 1 � � `� �K._ LOT �o�ADt1=.L'�_K�iy���L�-�o <br /> ` /' /� <br /> OWNE � `��F+'�I I�.LG.�' l/ _GONTRACTOR <br /> _j_FL _ ' _—___—___..._ — <br /> INSTALL_� . ETERED SERYtCR � <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCOPD�NCE WITN THE -� � 7I , � <br /> ORDINANCES ANC POLIUES OF THE WATER DEPARTMENT NOW EXISTING � � ���` /,: <br /> ON AS SAME MAY BE HEREAFTER CHANGED. s�crveo: X +--{�______G\uL.c_�. <br /> - - MMERIALS ii IN.Ir 1 IN. � 2 IN. ; � P1(I AMCUNT <br /> PIPE��, �:' .'�;i . !�n"_ COPPER--GAW..-STEEL I�J� �_ �I _ _ _I_— <br /> ! I <br /> CORPORATION `� I � - - �� .5 I I i <br /> CURB Cr`CK OT I I <br /> SERVICE BOX PLASTIC •• C 1 � <br /> — ___—.. <br /> METER VALVE 'l f� - <br /> — ... _ �-�L____�._.— __.__--____._ � <br /> METER No. �.__`�, � �'..� _..TVPE� ' , ..� . �� I .S / ---- _ _._ ____— <br /> METER BOX CONCR��-C�r�'ISMALL � LARGE � ! <br /> '-- __ ___ ___ <br /> � __ .' —�'_ _._ __' —'__ _' —.— <br /> � . � � I i <br /> '-- .�' � ��\ � I _I�--L.. <br /> __ ._ �v\ {��._� s� _—'" � '_I _ _�_— _ _ �I — <br /> 1 <br /> � ���____"_ — <br /> J _ <br /> I �� _ � <br /> I I <br /> fyi� ON <br /> �ATE INSTALLEO: � � / ��� � OFF �UB TOTAL <br /> b <br /> CO�[ LABOR ANDEQUIPMEN'fPENTAL HOJRS RATE <br /> y I' ;i.J•_ �.a �'_ — <br /> --' .—_— _—_ 1:.. _"—_ —�c`�� _ _ —_'_ <br /> J <br /> _ _ _ � �_/_���'�� � �'� I� ---- __ __ <br /> _ <br /> � � � � <br /> . � . _ <br /> , ; , ,. <br /> -- - - --- ----_ ------ - ---�_- - ---,-- <br /> TOTAL <br /> REMARKS: <br />