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APPL�f��T,F-�J SERVICE I <br /> No. pC J � CITY OF EVERETT ORDER fd0. � <br /> APPUCATION �'OR WATER SERVICE d� `� ' � � <br /> � FI%ED �A`/�./G 7 ij —' j�l� <br /> � DEPOSITs 73��� s9�_..a�_._ a�rr <br /> _� W. O. <br /> �f _ No._ _ <br /> 3ERVICE cer�ooqeee�,{ Q� C,2�"�✓_�___�Lr-G" BLK._ LOT_3!.�(yfdy2�%`-e=l�..,�.•� <br /> OWNER_��c ������ACTOR. <br /> , C., -- <br /> INSTAL METERED SERVICE__ ____ <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH TNE � <br /> ORDIIIANCES AND POLICIES OF THE WATER DEPARiMENT NOW E%ISTING � � � <br /> OR AS SAME MAY BE HEREAFTER CHANGED. slcNeo: % __ __ �yr� <br /> MATEHIALS � IN. 1 IN. I 2 IN. I I I Pp�CE AMOUNT <br /> P�PE �',t�j��� COPPER•-GALV.-- STEEL � j <br /> CORPORATION <br /> L__ <br /> -- f_ I <br /> CURB COCK OT I I � I <br /> SERVICE BOX � <br /> PLASTIC -. C I _ f I I— <br /> METER VALVE -- � <br /> METER No. — — — <br /> —_--_ 7YPE: __.___-._I `—___ _—I___I___ _ <br /> �7ETER BUX CONCRETE SMALL LARGE <br /> � <br /> �.�. �1— .uo 3 L!%_L''!i���5_rtcl�Ll� � � _ <br /> --_N=iS �r5 �'` _._ I <br /> ���.��t_� i, �� :i I <br /> - i --I-- - <br /> ----- --- � -- - _ <br /> --� - --- <br /> -- --------�--� -�-- ---- <br /> I ❑ ON <br /> DATE INSTALI.ED: .�/�� � /,� �pFF SUB 1•OTAL <br /> Y <br /> CO�E I LABOR ANOEOUIPMENfRENTAL I HOUR9 RATE <br /> I �'n`� � I J_ —I�—�� <br /> ����-C-L7__�_l_ � - LL -- — ---- -- I .` <br /> —��-1��H'_��.�- - / ,�J �j`�/� � I 3 — - <br /> —��-------- - - — — - � 3 -- <br /> i�' �1 c' --- ----' 3 <br /> — ------- <br /> -- --__ -- <br /> �� -- — —-- - --------�— <br /> TOTAL <br /> REMARKS: <br /> Y <br />