Laserfiche WebLink
APPL. � • ?�� APPLICATION FOR SERVICE SERVICE �1�� 5 3 4 <br /> No. OR�ER <br /> � �� ; � GTY OF EVERETT WATER DEPT. <br /> y� FIXED DATE_--___i9_- <br /> i <br /> � DEPOSIT �c %����, - _ N O. - <br /> SERVICE (BvnoDRE98)—��'( /`�, ' �y�� BLI<.�LOT_--ADO.— .— <br /> I % <br /> OWNER___r' ~ � ' �'_-�_L� I-------CONTRACTOR ���I : , . ___ .. <br /> -Pt94T-- '.� : <br /> INSTALL_�/_METERED SERVICE_ .--- -----� � 7- --- <br /> I HcPEBY APPLY FUR THE USE OF WA7ER IN ACCORDANCE 141TH THE � � <br /> ORDINANCF.S AND POLICIES OF TNE WATER DEPARTMENT NPW E%ISTING �" -j �iy,�-- ���. ^ ` <br /> OR AS SAME MAY �E NEREAfTER CtIANGED. 6IGt�y X_ t.._;t.,_ J-�- — - <br /> -- IR�TERIT.LE �i IN.'` f �N�I 2 I{J. I I 1 P IC AMDUNT <br /> PRPE �COPPER> GALV.--STEEL � I� � � I � <br /> �� <br /> CUR�ORATIUN ,K�,�..� („_. / � I I I'', � <br /> CURB COCK OT I �` II <br /> SERVICE BOX PLASTIC -- C I I II <br /> _ AIETER VALVE __________'__ _ I __ _ _��..�� <br /> METER No. '(�j�/�7Sr TYPE: �`/� ,,`. I 3S S�� ^ <br /> _7' —_ ���, <br /> METER DOX CONCF.ETE __ SMALL!_ LARGE L 1� <br /> I L_) <br /> I I <br /> __._'- __ I _ ��I_ <br /> � <br /> -- --- - -�--�-_j �'�.� <br /> ❑ o�.� /� <br /> DAl'E lNSTALLEO: L _ �+ �-�, �OFF , .�C� �u�. . SUB TOTAL �-I� ��. <br /> / 1 <br /> COOE I LAkIOp ANO EOUIPMLNf RENTAL I IIOURS RATE <br /> iy_'. , � - __ � G., � <br /> --�--- - I�I I � <br /> � - - - ��- -�- � � � <br /> ' � � ' <br /> --I I I�; � <br /> -- - -- -�, - ---,, � <br /> -�- -- - _ _- ---- - -------i-- --�I--I- <br /> TOTAL iI ����l:J /�' <br /> REtdARKS: - <br /> ^ /. <br /> . .�.�«..�:2�_i.�..`-:-.-��-vLe-•".� .-_'. . . __- - _ _—_'__--" ."_ _—__.. <br /> _ _ . . . .. _ . . _- _ <br /> �� <br />