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' S ' <br /> APPL. ���bG� y� ��` g APPLICATION FOR SERVICE SERVICE {v° 'I 4 � O <br /> No. ORDER <br /> CITY OF EVERETT WATER DEPT. � I <br /> /D DA�iE �-��_19�r <br /> Li�fX <br /> �'D W.O. <br /> � DEPOSIT s���_ No. <br /> G� (J�nU / �� / � ���� <br /> SERVICE (BY AooREes)—G!�—G�4�����`�---�--s=�--6LK. � LOT � ADD.— <br /> OWNER J 1/��L L 57�� CONTRACTOR V ���--L� � <br /> !� FLAT '2g01 / L�Lv/>T /a ��. <br /> INSTALL�METERED SERVICF ^ <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH TNE ,�..,// —4 / <br /> ORDINANCES AND POLICIES OF THE WA7ER DEPARTMENT t70W EXISTING �`n, J ' � <br /> OR AS SAME MAY BE HEREAFTER CHANGED. sicrvr.o:X.+e��y?ua — �..64�1~ -- <br /> MATERIALS 3i IN. 1 W_� 2 IN. I_�_I Pp�CE AMOUNT , <br /> PIPE _ COPPER•-GALV.-•STEEL _ —L— II_ I _ <br /> CORPORATION I II I <br /> GURB COCK OT I � I — <br /> SEiiVICE BOX PLASTIC •• G 1 I I I _ <br /> 'dETER VAWE ( —� <br /> METER NO. TYPE: I ?6 __ _ __�. <br /> METER BOX CONCRETE SMALL LARGE I <br /> —' _ __ I <br /> _ — I _ �I_ <br /> I_ <br /> —_ — I � <br /> I <br /> � ON <br /> DATE INSTALLEO: � OFF SUB TOTAL — <br /> CODE � LADOR AND EQUIPtdENT RENTAL. I HOURS RATH _ <br /> I __ -_ ; <br /> � <br /> I ---I�---II— <br /> � � <br /> � -- - - _= j !I I <br /> � -�� � - <br /> � --------- - �- <br /> i <br /> � TOTAL <br /> REMARKS: � !' Y �� r !' - � i ^, ( . . . . =' ' . . . ' - .!_' <br /> -�5��---�=-�-- -'< --- - -�---- : —-- s. <br />