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APPLI � � �` p APPLICA'fION FOR SERVdCE SERVICEN° 484 <br /> No. ' ' � OR�ER r. <br /> ������� CITY OF EVERET'� WATEf2 L1EPT. oAT��, '✓/ / �19,�y <br /> � FIXED �� �,� �� — <br /> � DEPOSIT g /�.lL�, j N O. �' <br /> �j`� � <br /> SERVICE (eY+�o ess)�"7�'"�L� ���t� BLK. LOT—��AD/7.� <br /> OWNER ��`'t.�""-'/ `-�. � CONTRACTOI' � �:> I'"� �•b �' .Z� $-L��J�=L— <br /> 1 �� � i <br /> WSTAL� � _METERED SERVICE_ _ �` <br /> I FIEREBY APPLY FOR 7HE USE OF WATER IN ACCORDANCE WI7H THE <br /> ORDINANCES AND POLICIES OF ;HE WA7ER DEFAR7l�ENT NOW EXIS7ING <br /> OR AS SAME MAY BE HEREAFTER GHANGED. BIGNED: /� C g,-. . -�Cc+-�.= <br /> AtATERIALS �i IN. 1 IN. I 2 I . � PqICL � AMOIJNT <br /> � .� �^''- <br /> PIPE �COPPER�- GALV.-- STEEL '� ��( I • �J� �I „��jz <br /> CORPORATION I_ I� ��1 �I . <br /> CURB COCK OT I __ � <br /> SERVICE BOX PLASTIC -- C 1 I <br /> METER VALVE � (���. <br /> METER No.tl'���--,�,i`/47�/S._ TYPE:�.'� ' I -- --- � ''�_ <br /> . �,-�. r. :� <br /> _ ___ <br /> ...__.. .,.� / _� <br /> METER BOX ��CONCRETE l __(�S _MALL LAFtGE _L � - <br /> - -- -- r . � ! ��' � — -�%� <br /> � � � <br /> —� —� � <br /> � � <br /> —I — -- <br /> � � � <br /> � oN i <br /> DATE INSTALLED:�� ,�� � . � I �' �FF SU6 TOTAL �Lf� � <br /> J <br /> CODE I LABOR AND EOUIPMENTRENTAL I HDURS RATE <br /> I' ��' � I L � ' � � �� <br /> I I� <br /> I ' �,;% -� 5 �, ; �� , .� ;-- <br /> � i I;—�-- <br /> — 'I -- ----- ---- ---- I. � �I� ;-II '— <br /> I �_� � � � , <br /> TOTAL I /lJ� I J�J <br /> r <br /> REP9ARKS � . � � � � � 1 <br /> J�—_--- _— _—_ _—__ �, <br /> / !` ��1 . . - . —.—L _ <br /> � <br /> . <br /> I��'- ') v <br />