Laserfiche WebLink
-, <br />No. �,'� APPLICATION FOR SERVICE SERVICE N2 1984 <br />"° II J� CITY OF EVERETT WATER DEPT. <br />FIXEDDATER_EI J� I>�s <br />^' _( /�(/ <br />DEPOSIT S f �• Q Q No O. <br />2)61ZC PL, SAC 3s=a9-5` <br />SERVICE (BY ADDRESS) <br />�( .LOTADD <br />OWNED `.'�`��L-- 6� CONTRACTOR <br />FLAT <br />INSTALL ky iM0111111101M SERVICE <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:X <br />MATERIALS <br />V. IN. <br />I I IN. <br />2 IN. <br />PRICE <br />AMOUNT <br />PIPE <br />COPPE <br />- GALV. - STEEL <br />CORPORATION <br />CURB COCK <br />OT <br />I <br />I <br />I <br />SERVICE BOX <br />PLASTIC <br />METER VALVE <br />_ <br />METER No. <br />TYPE: <br />METER BOX <br />CONCRETE <br />SMALL LARGE <br />I <br />I <br />-- a fe — <br />I <br />I <br />DATE INSTALLED: /�_ <br />® ON <br />I OFF <br />B TOTAL <br />COOT' <br />LABOR AND EQUIPMENT RENTAL <br />HOURS <br />RATE <br />"TOTAL <br />REMARKS: fLl4 <br />