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�/ / QR�"-�� SERVICE N? 2035 <br />/_ ,� i/T �iPFLICATIO�i FOR SERVICE OFtDER <br />APPL. /% �����r/ <br />No. �� CITY Ot- EVERETT WATER DEPT. �.;/��� _19�5'� <br />DATE—� <br />i <br />�f�IXED W a• _ <br />, %�(�t ✓ No. <br />� � DEPOSIT 5 �-// �'/Y,F <br />,' SERVICE {e ADORE66)1��?�=�—^—�--�'�'—O� BLK._---�-�%T—G/ _ADD���/'- �"'�1 <br />�CZ�a-�O _CONTRACTOR_—__.-- --'-- <br />I OWNER � G <br />' I� FLA'F �----- -- /7; <br />� INSTALL�--A7Gf'�'e"�"•T��,•,-•- . /� � <br />�I I HEREBY APPt1' FOR 7HE USE OF WATER IN ACCORUANCE WITH THE 61GNED�'� �K -����-�-�—"-- � <br />� ORC:NANCES AND POLICIES OF 7HE WA7ER �EPARTMENT NOW E%ISTING <br />OR AS SAM£ MAY BE HEREAFTER CHANGEO. rpicE AMOUNT <br />IAATERIAL6 �/� IN. 1 IN. j 2 1 I I <br />` �-�\ - ^/ ���-�I � <br />� o P=_ r� _pppERJ GALV. -- STEEL _ <br />I�— —CGR—PORAT�ION <br />CURI 6 COCf( <br />� SER~- V�CE 60X�_ <br />I METER VALVE <br />� METER No_ <br />, METER BOX <br />II <br />OT _ <br />?LASTIG <br />CONCRETE <br />Wa-s / c <br />� (fti e 1: <br />/ , L[LP�� <br />� OATE IVSTALLHD: <br />COOE � <br />F i .7/.l . � <br />TYPE: ____' I bA <br />SMALL LARGE_ <br />pOc_ �Jci/. <br />�--'-- <br />, 2,./— Clo Sr f <br />� O _� _'__ <br />� � ON <br />G oFr• <br />' �pBORANDEqU1PMEN�fR[NTAL <br />� / �� � ' y <br />J��' ___—,1TC�--_ <br />..'�" cc,, o.f_tc�; O�_ _ — <br />,—�-- ��% ; , G <br />� �� �� �� ,., ; ., _ <br />B TOTAL <br />HOURS � pAT� <br />AL <br />I REMARKS: ---� - <br />-- <br />_— — - — <br />I- '_—_-___.__". _. <br />