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J� <br /> � <br /> APPL. -y.� � � � - �� �� <br /> rya, LL��.3� APPLICATION FOR SERVICE SERVICE jv� '� /! �' ;j � <br /> C11''Y Of EVERETT Wd1'ER DEPT. oROER ; <br /> �- ; <br /> � DATE__�_�ZC�J _i B�_ <br /> � <br /> � OEPOSIT c/�� ��_ W.O. <br /> j�9 tio. ----- <br /> ���/5 y t �L'E�e�T <br /> SERVICE (aY qDDRess� 6L�LOT�pp,�/Il� L <br /> OWNER—r (L'�:_.f�G�T/I/I�/�____CONTRACTOR S/4/�7l- <br /> L��Y (( FLAT —_—" <br /> INSTAL l �MPxAw�rr*'SERVICE—__ <br /> I HGREBY APPLY FOR THE USE OF WATER IN ACCfRDANCE WITH THE / � <br /> ORDINANCES AhD P'JLICIES OF THE WFTER DEPARTIdENT NOW E%ISTING /�I� /� �� /'�. <br /> OR AS SAME MAY BE HEREAFTEft CNANGED. 51GNEo:X_L�4_CLili._y__ t•-� �.�. _ __ <br /> L1AiEfilALS �N IfL I 1 IN. I � �N. I PRICE AMOUNT <br /> PIPE _ � � I <br /> .COPPER-- GALV.-- STEEL � �� <br /> CORPORATION _�__ I_ II <br /> 7 � �) <br /> •'i'RB COCK -O.L ' � I�J�( <br /> � li��"/✓.- <br /> EERVICE BOX p � .� - C I I I � � II �I�7_-' <br /> METER VALVE I-- I <br /> METER No. —.______—=TYPE: I s -- —__ — —.__ ___ <br /> METER BOX_ CONCRETE _ SMALL LARGE f I— <br /> �T-/ I _ � I �r�j <br /> -- j !—I- I --� <br /> -- � '--�- — <br /> -- ---- �-j- j I I � � I <br /> � ON <br /> DATE INSTALLEO: . ' J/ �LOFF J/� ��� SUB TUTAL /% �i!_ <br /> � 7 <br /> COOE I LABOR AND EpUIPMENf RENTAL � I I '- <br /> MOUaS � qhTE <br /> ---�.�.�•-=---- - --- ----�—� =S-�I �� �Z 3_ <br /> , , <br /> — — --- � _�� �_ <br /> —--I�-�-�------ —-- I==— = ✓=� /-`� I 2 3_ <br /> ---- � II I <br /> --,— ------- — � I� I -- <br /> --i I —�'�—�I — <br /> — i �-�---- ----- — --- — -- ---i-- --'I L� <br /> ' _' TOTAL I ¢ 7 I✓O <br /> REh1ARKS: <br /> , <br /> _-__—_ _—-_._...' ___ . <br /> -� <br />