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Y <br /> APPL. ' �� ��� APPL•ICAZItlN FOR SERVICE SERVICE {1J° d ] 6 <br /> No. OR�ER <br /> ����3 GTY OF EVERETT WATER DEPT. �' -�J / <br /> � FIXED � DATE '��� /`�gb� <br /> /� 1 <br /> � DEPOSIT S ,�O(/. �� � N � � <br /> / / / �C�7�7L7yLE'-L(�C'�E-li ,/ - <br /> SERVICE (BY AUDRE56)�!-`�'C`-' `� BLIC. LOT�/�DD. <br /> OWNER _ _CONTRACT�L�t"��!����`���. <br /> 3 �[ '� FLAT � � <br /> INSTALL Mi?iRBD-SERVICF' _ - <br /> � OR E SASAME MAY PBE IHER'eAFTER CNANG D DEPA TMENT NOWWE%STING 91GNED: X��/������ � r ��� ' ���' � � <br /> — MATERIALS I �/i IN. I IN. I 2 IN. �� PRICL AMOONT <br /> PIPE -"COPPER•-GALV.--STF.EL � _�� ,� <br /> CORPORATION � � ..� � -- �� %'i l� <br /> CIIRB COGC (OTj � _—�I <br /> SERVICE BOX � PLASTIC� •- C I / I II ��",� <br /> ME7ER VALVE --- _ _ -- _— �� I <br /> I I <br /> METER No. TYPE: I !{ �_ � <br /> METER BOX CONCRETE SMALL LARGE -{ <br /> -. ' � � I I��� <br /> ..- <br /> -� - - - ��- <br /> I <br /> I <br /> I I <br /> � ON <br /> DATE INSTALLED: �- OFF _ _ SUB TOTAL /` J� <br /> O <br /> GODE � LABOR ANDEQUIPMENTR[NTAL MOURS PATE <br /> I —__ —� �` <br /> _� � � � <br /> � . I ..�( �I / I�i/_ <br /> I - -I -I' i� <br /> � �_ il_ I <br /> � _ - � I � _ <br /> I I TOTAL �J�C <br /> REMARKS: �� � _ _ ��% <br /> .. . � <br /> —J- <br /> � � / ,, a . � . <br /> _ L11S-'-�5�� ' . : .� �� � .� % . .. . .i'. r . ' . t'� �--��_+-. <br />