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�pPL ���'° �� APPLICATION FOR SERVICE <br /> SERVICE N� ZO� 2 <br /> CITY OF EVERET'�' WATER DEPT. oR°ER <br /> i ��FIaED /� �,f/ <br /> I � DEPOSIT g '�J`J�/"�(� DATE�_ V`�` 1 B�_� <br /> I W.O. <br /> �./} � /j �7 � � �f/�+ AN/0./_ <br /> � SERVICE fe AODREg9/) /" ��_S`J ���y(/��NL j' L�/YNL�/ Tf D �.I�O,� <br /> � OWNER��_ �sl / �!) IElG,�� B I<. ADD. �-.ti��r�lF-�_- <br /> � ,�- -_GONTRACTOR <br /> I �NSTAL� � � M`���G�7ERVICE___, - <br /> I i HEREBY APpLY FOR iHE USE OF }4ATER IN ACCOF�ANCE WI7R iHE ) <br /> I ORDINANCES AND ?OLICIES OF THE WATER DEPARTMEN7 NOW EXISTING /L � <br /> � OR AS SAME MAY BE HERL'AFTER CHAN6ED. �/ <br /> 91GNED: X. "✓ i _ p'�%7A,i�C� <br /> � M TERIAL � �-- <br /> —�__ % IN. 1 IN. j 2 IN. I—,I ' PRICE AMOUNT <br /> � P�P�__ COF'PER - GALY._STEEL I — <br /> �I -C--OR�PORATIOY -�-� � <br /> i �-U� k8 CGCK OT = �J <br /> SERVICE BOX� PLASTIC -- C I � � � I <br /> I�METER VAWE __-_-- <br /> I (l <br /> � A9ETER N_p_._�,S��:Csl-_ TYPE: �� ___- - _-__- _- _-- <br /> � �s// ��— / -- -- — <br /> M�TER oOX CONCRETE _SMA L ) l(qpGE <br /> � /e o o y� c ----� <br /> �-.� ��� ('��O �'/�i O � I I---- - <br /> L�-�C i., ��k 13v51z, � ��_ — - <br /> � .�`� �.5�'n ��., -L _.� <br /> � _ S-�f�� j� � � — — <br /> i— <br /> �---E��— �s�S ,��l �� i���, ���)��I—_ <br /> I �` <br /> -�/X�_Y� /faY'A 6A� �o .dn dIn e I I I I 1 - <br /> iby Sr r. r� .O��,r� z"d.r�ol � oN ---- <br /> OATE INSTALLED: � ��� � / �� <br /> �- � "1S � XS [� OFF b� SUb TOTAL <br /> � �j.���� LABOq ANO EOUIPMENf R[NTAL ����� �� � <br /> � / , � HOURS ryqTg <br /> � I - �� 6 <br /> � � 1 <br /> �---- <br /> I--I�I I__� � J <br /> � Fy u'", i�i C�a Ir��a r�i«cd I_ �� - <br /> 1 v <br /> � � G.i f� G!/rL7eh��/ri. I�� --_ <br /> i_ I , �i -__---____-__ I_�Z� <br /> � � ^ �� � �r!— --- �_�� <br /> I " ' �,��_ � -� <br /> I � CIi� «���>.� ,� �_ -- -- � �- <br /> i � '�---- � <br /> � REMARKS: -- _ --- - TOTAL � <br /> I <br />