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NOPL `�"�" �� CITY OF EVERE7T ORDE'RE N� 6785 � <br />APPLICA"iION FOR WATER SERVICE y� <br />� FIXED DATE � �� _�g�`} <br />� �EPOSI7 s _ � � w �'d. O. <br />_a''\ <br />No.__ <br />SERVICE (Br AODREee)—���� ��C•I��BLK._ LOT. y —ADD.__ <br />OWNE P ^— ���'—'"' -- CONTRACTOR /'��� . <br />. y FLAT ����,7 / / -- <br />INSTAL � ED SERVICE �— — <br />i q <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH HE �/ <br />ORDINANCES AND POLICIES OF 7HE WATER DEPARTMENT NOW EXISTING ���� �ivu <br />OR AS SAME MAY UE HEREAF7ER CHANGED. etcNro: X <br />MMERIALS ii IN. 1 IN. � 2 IN. I I�� PRICE AMOUNT <br />PIPE __ _ COPPER -- GALV. -- STEE _ I I <br />I <br />�:ORPORATION ' ____ �_I� __ _ <br />CURB COCK OT � I <br />SERVICE BOX PLASTIC -- C 1 I � <br />—J___ — <br />METER VALVE � <br />_ ___.__ --_-- . — <br />__ — __ <br />_ ___'___ __ '___. '_'— <br />METER No. TYPE: _I=9 _ _�� _ _ _ <br />METER BOX CONCRETE � SMALL LARGE _ _ ___�_I _ _ _ <br />� <br />DATEINSTALLED: <br />COOE I <br />�i�(/�---�- - Q % <br />-.I-_ <br />� �� <br />REMARKS: <br />I� OFF 5 � <br />LADOR ANO EOUIPMEN'fRENTAL <br />`_��a,� �y_�'_. <br />/ SUB TOTAL <br />I HOURS I R4TE <br />I <br />TOTAL <br />