Laserfiche WebLink
APPL. <br />No. <br />vG // %L <br />FIXED <br />F <br />DEPOSIT i <br />SERVICE MY ADDRESS) /J - <br />OWN E <br />-APPLICATION FOR SERVICE SERVICENV 1148 <br />CITY OF EVERETT WATER DEPT. oRDE' <br />INSTALI / r - METERED SERVIC <br />DATE_- � L17 <br />W. O. <br />No. <br />BLK. LOST_ -ADD.- 3� c,• <br />CONTRACTOR — ' <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGNED: <br />.....'_"'"'_„ <br />PIPE <br />I N IN. <br />I IN. <br />1 2 IN. <br />PRICE <br />AMOUNT <br />`COPPERj• STEEL <br />[�4• <br />/ <br />!� <br />�7/ �C <br />✓� <br />CORPORATION <br />CURB COCK OT <br />r <br />��/ <br />SERVICE BOX PLASTIC -- G I <br />METER VALVE <br />METER NO..,V6, TYPE... <br />�Ci2 <br />METER BOX CONCRETE <br />A ,LARGE <br />DATE INSTALLED / - / <br />Ej ON <br />Er --OFF ���' tt <br />Y <br />SUB TOTAL <br />7 <br />C <br />J <br />CODE LABOR AND EQUIPMENT RENTAL <br />HOURS <br />RATE <br />--We <br />S i O-�! P1@%r <br />rtG./v� �_ <br />J'. ✓ 4 <br />/ �-(c/•v <br />p <br />��,•P�k "��/tie <br />,17`a <br />I <br />TOTAL <br />II// <br />�L^� I(o� <br />f -,I r' <br />-- <br />