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i <br /> SERVICE `1 �� :� 'l <br /> APP�-• p�3 a O� CITY OF EVERETT ORDER NO. �} :'" �� <br /> No. APPLICATION FOR WATER SERVICE p <br /> � <br /> DATE�� —19 0/ <br /> � FIXED 'r W 0 <br /> � DEPOSIT s � 3�S No. — <br /> SERVICE �avwooneesl /-� �� / � � G�`����� <br /> aQ BLK._ LOT ADD. <br /> OWNER___L��� �"�� CONTRAGTOR <br /> // <br /> INSTAL�METERED SERVIGE---- <br /> ORDINANCESPAND POLIC ES OFETHE WATER DEPARTMENT NOWWEX STING _ �, � <br /> OR AS SAME MAY BE HEREAFiER CHANGED. sicNeo: X.—_ -- - - <br /> M/�TERINLS <br /> �/i IN. 1 IN• I 3 �P1' I ( PR1C[ AMOUNT <br /> PIPE �, ��C / COPPER••GALV.-- STEEL � <br /> CORPORATION ("'� SOOS I <br /> CURB COCK OT —I — <br /> SERVICE BOX PLASTIC - G I � — — <br /> METER VAWE .___ — ----- <br /> METER No. TYPE: I `S _ -- - — <br /> METER BOX GONCRETE SMNLL LARGE _ ___— <br /> ��y /��'h Re�: - 1— i — <br /> '� o� � -- — <br /> - ,-�.r S 'I — <br /> -- I — <br /> I I <br /> I ON <br /> � �I A.-� � OFF SUB TOTAL <br /> DATEINSTALLED: � ❑ <br /> CODE � LABON ANO EOU PMEN�f RENTAL I <br /> MOURS RATE <br /> � _ s_�p- _��1� <br /> i ��c,�m I �� - <br /> ,les — .�t"Zll �:�� -- <br /> � ���— � 364��� <br /> i � <br /> I -- <br /> I ---- <br /> _— I TOTAL <br /> REMARKS: - <br />