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APPL' /��6 � APPLICATION FOR SIERVICF. SERVICENo � �j E <br /> No. <br /> ����� Cl/���-QF EV'ERETT W�l,TER DEPT. ORUER <br /> � Fix o �j �J DA I� �/ <br /> /s /P� _ �!vU?i,�-7l-zi-f�i� -�j��---�R� <br /> � DEPOSIT g�eJ l�2lz � � <br /> _ � w. o. <br /> ///�. No._ <br /> SERVICE (er nDoaessl�_�O� �-T�^����Z-��(�'-��, LOT ADD. <br /> �N_R�7--- CONTRACTOR _ <br /> tiF.tV � FLAT <br /> �h�+4��METERED SERVICE '�"=��'Z'L� �. 1 <br /> I HEItEBY APPLY FOR THE USE OF WATER IN ACCORDANCE '�YITH THE � e <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTN.ENT NOW E%ISTING � • ��2 / �� ���`� <br /> OR hS SqME MAY qE HEREAFT�R CHANGED. s�cNeo: X__ �t� ��-R',.`L' <br /> __ :.IATERIALc �/� IN. 1 IN. 2 IN. ° <br /> �_ <br /> I I I � PRICE ANOUNT <br /> PIF�E COPPEf?" GALV..-STEEL ___� —I__ —IT'- . J"r� I� / lJCO <br /> CGRPORATION — — — —� — �I�- <br /> SURD COCK 07 I I <br /> SF?RVICE 60X �pLASTIC� -. G I � I — ��� <br /> M'eTER VALVE I �--II �� <br /> METER No. TYPE: _ I �, — i - - - I—�----- <br /> —_ --� — I <br /> N.ETER BOX �ONCRETE SM.1LL LARGE � I � <br /> — ��J�� � � � <br /> -- �_�L_ � —I —�I�u� <br /> ---- � - I--I_ <br /> � - <br /> — — — _ � <br /> -- ---- � <br /> _ � � ; <br /> �-O N <br /> � I <br /> _ DAT� INSTALLE�:. ; . , I � OPF � SU0 TOTAL g �'7�J <br /> .. I �/ . � ., //� <br /> CO�E I LABOR AND EOUIPh1ENT R[NTAL ' <br /> � I��,^, I IIOUPS pATE <br /> � 6 t -- �� .�s 3 � o C <br /> � `��•�. 0 I Z o�l � I� <br /> � i <br /> , --- -- - - ''- ' - <br /> --i — — — -------- --- I--- --��I— — I----_ � <br /> — I <br /> TOTAL ��IJ� <br /> f.`EMARKS: � <br /> -_.____- I <br /> ._'._'—___-'�___'______'-'__ ._._ <br /> '__' ___— —_'__' �< <br /> ._'_"__ '._._..�...___.��_. . � ... i <br />