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� <br /> A'�PL' p����� .4PPLICATION FOR SERVICE SERVICE N° 14 J 3 <br /> No. <br /> CITY OF EVERETT WATER DEPT. ORDER <br /> �FIXED �O r �ATE1s�a 5 _�g 7I <br /> G+ DEPOSIT �� W.O. <br /> No. <br /> SERVICE �Br�ooAEes7_ R6iZ7"' F/'7F�.SON 7/J7 �43LK. _LOT 3_�noo.rnERsuJ FAaK <br /> OWNER�y �ILL/S CONTftl,CTOR__lLL��G�S NCHGS <br /> � Ft.AT <br /> INSTAL��gE <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCOflDANCE WITH THE <br /> OROINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING C / � " <br /> OR AS SAME MAY BE HEREAF7ER CHANGED. sicN[o: X—.[�� � � • !`� l/�,�i , <br /> MATERIALg � IN.� 1 IN. � 2 IN. I�_IT_ PRICE AMOUNT <br /> P�PE COPPER-- GALV.--STEL'L _ I I <br /> CORPORATION I_ �I I <br /> CURB GOCK OT � ��I— <br /> SERVICE BOX PLASTIC -- C I I I <br /> METER VALVE <br /> _METER No. __ _ TYPE: I ;6 <br /> METER BOX GONCRETE SMALL LFIRGE I <br /> —_ --_ — I <br /> —_ I I__ '—� <br /> � I <br /> I � — <br /> �/ I <br /> I � ON <br /> DATE INSTALLED: � OFF SUB TOTAL <br /> ' COOE � LABOR ANDEOUIPMF.NT RENTAL I HOURS PATE <br /> � �� <br /> — — I � <br /> I I I I <br /> I I I' _ <br /> � I <br /> I li I <br /> I <br /> __ __ I �� I <br /> _ I _ I _II`__� <br /> -- I — -_— i --- I TOTAL I� <br /> RE�fARKS: •� '� � � <br /> ��' �• vl �c� i i � � ( T_� T �;'�-. � . _,,�r�-.� <br /> _---/�%�__- -- -- ----- - <br />