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i <br /> IAPPLI�O �$ ./ APPLIC�4TION fnR SEYtV10E sERwce N° 1 736 J� <br /> No. ORDER <br /> CITY OF E'VERETT WATER DEPT. <br /> � �XED DATE��—.19� <br /> � O <br /> ; � DEPOSIT s �O Q ' No�� <br /> � �n �.� _ 1 � C-M�fERsoN <br /> I SERVICE (e�r^1DOReae)_L�1L�^�L`1E'.R.�r�� �L' BLK. LOT� �1 ADD. 1--�"2k <br /> ' OWNER�L�S L���.� �G • CONTRACTOR��'� <br /> � �L(1 FLAT V '"� 5��� <br /> I I NSTALI 3LS—_MG�lflL'D'SER V I GE—__ — <br /> � I HEREBY APPLY FOR THE �SE OF WATER IN ACCOROANCE WI7H THE <br /> I OR ASASAME MAY BEL,HEREAFTER CHANG D DEPARTMENT NOW EXISTING s��Neo: X_ L��I--S— -- <br /> MATERIALe �ii IN. I IN. � 2 IN. I 'i I PP�CE AFiOUNT <br /> � plpE COPPER-- GALV.•-STEEL I _ <br /> I�CORP—ORATION �� __ _ <br /> GU� RB COCK OT I I <br /> � SERVICE BOX PI..ASTIG •• f- 1 �_ __� I _, <br /> I METER VALVE <br /> � METER No. __ TYPE: I !6 _ _--- -_ - — <br /> r <br /> I METER 90X CONCRETE SMALL LARGE_ _ _ _ _ <br /> � I I <br /> I I I_ <br /> _—� �_ <br /> � __ _ I' — <br /> 4_ _I �_ — <br /> I � � � <br /> � ON <br /> ' DATE INSTALLED: � OFF SUB TOTAL <br /> CODE � LABOR ANO EQUIPMENfRENTAL I HOURS RATL _ <br /> �I I <br /> I � __ I <br /> I " <br /> � I, I� _ <br /> � � �— — <br /> � I -- � <br /> � I__ � — — <br /> —/�l—�------- I <br /> i— I `J — TOTAL <br /> `�_ <br /> I REMARKS: � � � - - � � " - <br /> ,� �' ' �"--•••_ -.�- <br /> � ---����_-- -- _-- -- - - <br /> r <br /> � ---- ------ ---- - -- - - - <br />