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APPL ��•(y� �I��" qPFL16:ATi0N FOR SERVICE SERVICE (v_ $ � f� <br /> No. . o C <br /> � ORDER�- <br /> ?�; ;� -' CiTY f�F E1�ERETT WATER DEPT. i � � <br /> � FIiCED, / GATE =� / - �._19��. '_'' <br /> i�r <br /> � O�POSIT 5 E.'�. , _._ <br /> _ , W. O. <br /> i No. <br /> 1/ % (. <br /> V 0 <br /> SERVICE (BY qDDPE55)_/,C���f / /'-'�"�� ` - -=� � � '-7� / <br /> --OLK.-�—LOT,•Ji .xD�G�v+�e-�- J <br /> ,%f. �. <br /> OWNER— —CONTRACIn - �� � <br /> ..I7�i,.Q� . <br /> IN57'AL �'/� � F17FT- -__ - +, <br /> L—._MLTERE� SERVICE <br /> I HEREBY APPLY FOR `F�E USE 0�- WATER IN ACCOROANCE WITH THE ' , <br /> OROIKANCES AND POLICIES OF THE 'YdTER DEPAPTMENT NOW E%ISTING �-- -�7 �`4� /� /� <br /> OR A5 SAkE MAY BE HEREAFTER CHANGED. slci�eD: X < << " <br /> MATERV�LS �i IN.I 1 IN. � 2 IN. <br /> I�^_ PRICE IdOUNT <br /> �'�PE ��COPPER---GALV.--STEEL / � I ,J�J� I�l%! <br /> 1� d <br /> _CORPORATION � I II I <br /> CURB COCK OT I I_ I I <br /> SERVICE 80X _ PLASTIC -- C I I �I I <br /> METER VALVE _ _ / <br /> —I— !/ /i <br /> � -- Z J <br /> METER No.�� _ - � - -- <br /> - 11_Z1_-i�as,».�:7-rrPE: :���i:�:e� I sE> __-'�3��J <br /> __METER DOX CONCRETE � 5MALC1 LARGE � I ) <br /> ��L - -_ �� . <br /> _ �, , J� � �_ � �L�;,�;, <br /> _ ��/� -• � %-�;,�i_(=, --� - I�'3 <br /> , <br /> _-- � � I �J <br /> I --,— --__ I _ <br /> � � � � I�— <br /> I ❑ °N I <br /> DATE INSTALLEI�: �'OFF �; ' SUB TOTAL // , �� <br /> � i- .� , . r�_ _'. ' �T !. <br /> CODE I LFOOR hND E4UIVMENT RENTAL I HOURS RATE I� <br /> I"y„_ -- - - - --� ��r=-- <br /> -- I ��' j- <br /> �. <br /> - I�� J'.._� ^ ��—_ %.:��I -I -- <br /> I _ /�-� - <br /> I i _�'I I <br /> , __ i <br /> -- - - - ,I I - <br /> ------ -- <br /> -I---- - - - - -------I-- --I--�- <br /> �=% %7,I:i/ <br /> ' TO'fAL <br /> REMARKS� ../ ., ,." . , <br /> - ,; — a cu�._..�,..-C=�+- -- <br /> -� � — --- ----- <br /> , --- <br /> --� - - -- ` <br />