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qppL„��,� �J APPLICATION FOR SERVICE SERVIGE j1�° 4 H Z . <br /> No. ORDER� � �'� <br /> ��J�9 CITY OF E�/ERETT WATER DEPT. ��� ' � <br /> / „ <br /> DATE_� _ — -- <br /> fV FIXED <br /> W <br /> � DEPOSIT S �C O_� l��� N.O. _.-. <br /> SERVICE (UY AOORE56)���� � -" � � BLK.— OT `� �OD. ----- <br /> / <br /> OWNER __.—�y —CONTRACTO��� �"s' `� �?C�� /�� , <br /> ~ P ^ r�_ �-... . <br /> FLAT <br /> INSTALL���--MS-FSp6bSERVICE_.------ --- <br /> 1 HEREBY APPLY FOR THE USE OF WA7EF IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WATER CEPARTMENT NOW EXISTING <br /> OR AS SAME MAY BE HEREAFTER CHANGED. sl�rv[o:X — `-- -r=�-���t�"^� - <br /> MATERIALS 3i IN. f IN. I 2 IN. L—� PRICE h'AOUNT <br /> p�pg OPPE ?� GALV.--5TEEl. ��II •�'1 C�' I . <br /> _I3��--- ,� <br /> CC�)RPO-R�ATION I �I y <br /> CURB COCK O� I I I— � ' I�'� _ <br /> �- l � � <br /> SERVICE BOX LASTIC��_• C I _ _ __ <br /> METER VAWE - -- <br /> METER No. ��-- TYPE: I f" ___�__' _._ <br /> METER HOX CONCRETE 5�1ALL LARGE --{I I___ . <br /> __.—I � I — I— __. <br /> I I I <br /> � i � <br /> I I - <br /> I _ <br /> I I <br /> � ON <br /> DATE INSTALLEO: _ � �apF �µ� SUB TOTAL /!� L����,' <br /> / <br /> CODE I LABOR ANO EQUIPMENt FENTAI. � HOUFS PATC <br /> � --- �- � �-�_ <br /> I -i�_____i-- <br /> '�i,�� �-�-- -_l� �'=� . <br /> I �j I� <br /> i - __-�-- li i__ <br /> '���- -- -- - �-�-- ���-''I"_ <br /> � I � <br /> — TOTAL ���' � �� <br /> I <br /> REMARKS: ._—_..___..__. __—._-._��' <br /> -__—_—_._—____—_--_-__ __--___--_—_ % <br /> , _ <br />