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No. c- <br />❑ FIXED <br />DEPOSITS (jLT <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />SERVICE .1 "11`} <br />ORDER NO. <br />:. i'�! <br />SERVICE (BY ADDRESS) 4-y /'L1 <br />OWNER-�i/wf�.P/ .jo1�!•1a�.2�� CONTRACTOR <br />INSTAL, 5/� METERED 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 17 <br />_ <br />X_3i—f am <br />MATERIALS <br />COPPER -• GALV. •• STEEL <br />'A IN. <br />1 IN. 1 2 IN. <br />I PRICE <br />AMOUNT <br />PORATION <br />B COCK OT <br />[SERVICE <br />BOX PLASTIC •- C 1R VALVE <br />R No. TYPE: <br />METER BOX CONCRETE SMALL LARGE <br />DATE INSTALLEO:�� 1/-7 C' <br />r1s ON <br />( ++�p111 OFF <br />SUB TOTAL <br />CODE I LABOR AND EQUIPMENT RENTAL <br />HOURS <br />-7' <br />RATE <br />TOTAL <br />REMARKS: <br />