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�oPL• �� O�� � APPLICATlON FOR SERVICE 9ERVIC[N� �,rj��j' <br /> CITY aF EV'ERETT WATER DEP7. JRDER <br /> p�lRAED DATF �- � _16�� <br /> O O <br /> CI DEr091T S � . W O. <br /> No <br /> 9ERVIC6 (tY ADOPEB�I ��D / G�L7 -FKJ�� /-L . BLK. -� LO`T! "'f"/ �DD����.__ <br /> OWNER_�• G��/z,qL E z CON7RACTOR �i'� 7� MD�� <br /> IN•3TAL / l �/ ru� SERVICE /2n Z - i3c-.n-/�S,�i,(�r <br /> 1 HEREBY APPLY FOR TIIE USE OF WAiER IH ACCORDANCE WITH THE <br /> ONDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> OR AS 511yE MAY BE HEREAFTER CHANGED. ewNEo: X_. <br /> MAT[111AL� {: IN. 1 IN. � 3 IN. —� PRICE AMOUNT <br /> P�PE COPPER-GALV.-SiEEL <br /> CORPORATION <br /> CURB COCK O7 I <br /> SERVICE SOX PLASTIC •- G ( I <br /> METER VALVE <br /> __MiTER No. ___ TYPE: � � ---- ----�- <br /> MlIER BOX C4NCR[TE 9MALL LARGE <br /> _ ' _— i —_ <br /> '—I _ — — <br /> I <br /> _ _i _ _ <br /> I I I ( <br /> � � ON <br /> DATE INSTALLED: I � pFF SUB TOTAL <br /> CODE � L�80R ANO EqUIPMENfRENTAL HOURS RAT[ <br /> I <br /> — I _"_'�_ -___"_ ' . ___ __ - _--__I- — <br /> i _ I _ _-__ — <br /> __"___- _ _.- -" I—.-_ _ <br /> __—__ -.___-_—_. -- I __ <br /> v ' I TOTAL <br /> REA7ARK5: � ! � � <br /> _— __ - :� ; ^ ) � i___'.. i .... . �-;' , . , <br /> �-1-L__ �'=1___ / <br /> ����----- --.__ �__, _-_ <br />