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��9�i <br />� APPL. <br />� �o. �� 9� 7 <br />APPLICATION FOR SERVICE SERVICE Nn � �j q <br />ORDEF <br />CITY OF EVERETT WATER DEPT. J <br />DATE_L � � � _19 �� <br />� XED <br />I <br />� � DEPOSIT S��O � N �_ __ <br />I // �� , cP <br />� SERVICE(pVADORE95) •�`` ��C BLK��� LOYL zZADD.�v����� <br />� f n/ L _��y_ �'-.(/�/6 �FJG'✓/G� .� � <br />OWNER T�q� � cr. CONTRACTOR �_ N-`�< <-��CZ <br />I �e pLAT f�E'/DE .,S�Y/TE/.t ��CjCc RN.c�,) <br />I INSTAL� � _METERED SERVICE �702 -N, �5�_S�7L� <br />/L/5-4-/ 32z� <br />I 1 HEFEBY APPLY FOR THE ❑SE UF WAT'ER IN ACCORDANCE WITH THE //,, ���� <br />� OR ASASAME MAY BELIHEREAFTER CHANG D,DEPARTMENT N01Y EXISTING SIGNED:X�_�iL2c:_ � ��17Q{�—yj.73�j. <br />C <br />MATEFIALS '�'iIN. 11N.IZ�N. i � PRICE AMOUNT <br />i PIPE =G PPER - tiALV. -- STEEL ���-'—� ��i�-1 I� <br />CORPORATION K y,ft�/�i�,ti�„ � <br />� CUfiB COCK OT_ <br />I SERVICE BOX PLASTIC -_C I <br />� �METER �VALVE L�_n�{y� /�ei.n.rGA7�,— <br />� METE� R No. z3L�� _. TYPE' �'yry��YL i'n <br />� METER BOX CONCRETE f � dSMALL LA�_GE <br />� y.�o x S 3-l—,r 2,.----- <br />, , ,. <br />� Z X 3 1� c��y�'N /_��_2_'/of"Lc <br />I�,� �, <br />i y_I_Q� b=4LY=-!� -- <br />� � X � — -- ------ <br />� .�. .,� ,. - - .. __ <br />� I � ON <br />DATEINSTALLED: � pFF <br />COOE I LABOR AND EOUIPMENf RCNTAL <br />� I J. �bti„J�•� _ <br />I I 13 r��T� <br />� � L._rlr2 — <br />� � G.J A h L— -- <br />I D_�/_s� -- — <br />� d _ > >7 <br />�-- i <br />I REMARKS: i <br />�-_'—. -__'__ -} /�l�_ <br />/ '_ <br />� <br />-'�;:� i��� <br />-' _-'_ — _- . :- ' — ' __ -_ <br />SUB TOTAL <br />MOUFS � FAT[ <br />