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- i <br /> � SERVICE <br /> qpPL�I � � ElTY OF EVERETT ORGER NO. � <br /> No. I_T APPLICATION FOR WATER SERVICE -�7 <br /> DATE���-�-19_/-- <br /> �� FIXED W.O. <br /> / � � No._._ _._._._ _ _ _.._ _ <br /> n DEPO5IT s • <br /> �v'.-_. {--� � <br /> BLK._Z LOT�D AOD.I-`--`�-���T�'L�� <br /> �D�_�E=-�cvec2P�-2- „-]'Lr_ncc. <br /> SERVICE (ev woon si-� - - <br /> � ____- _ _ <br /> __-' <br /> __- _ <br /> �C�S _ (Z.L�'/�'iUN7. _ �Nl��__.--CONTFACTOR__ <br /> O�NNE�M_ _ -- <br /> F _ - <br /> INSTALL�C�-- TERE:DSERVIC _ - ---- - . <br /> ACCOADANCE WITH THE � � <br /> I HEFEBY APP�Y FOR 7V��C ei�N¢o;� - � -- - - <br /> OROINANCES AN� POLICIES OF TNE WATER DEPRRTMENT NOW E%ISTING qMOUNT <br /> OR AS SAME MAY BE NE.REPFTCR f.HANGED. rAic[ _ <br /> '/�IN. 1 IN. � 2 IN. L�� I <br /> pl/.IERIALS �/ I� -- ---- -_ _ <br /> P�PE �COPPER� GALV.--STEEI I____ I _I_- - - - <br /> CORPOHATION ____ '_ _ I� I � ____ _ <br /> CURB COCK_ OT __._ .- -_.__ . __ .'.- I� ___' <br /> PLASTIC -- C � <br /> SERVICE BOX _- � - - -� -- � <br /> - _ <br /> METER VALVE _ . ... . . . . .- ' --_ <br /> � TYPE: /�OyC'R . .� __ - = — -__- ___ <br /> METER No. �.I.L�y -.-. -- ' I _ _ _ <br /> CONCRETE SMALL LARGE_ __�_I - <br /> ETER BO _____'__ rS_A�� - - � - <br /> - -- <br /> -�--I <br /> -;;,- �-i,�t.�-_ - -- - -- <br /> � �.__ ---- � i - <br /> ---=Y—P,p - ;z--- I —1-- -- <br /> — -- --- — —II � I I; — _. <br /> � ON SUB 'tOTAL <br /> _" �y 7 or I � OFF <br /> DATE INSTALLGD: ��� �--� p HGURS RATE ,_ <br /> LAOOP AND EOUIPMENf AENTAL � <br /> CODE � <br /> 7)�c'I lt'�° l,vFL. — -- -- <br /> —�------ — _ - � n a s F� r• 7' � z — <br /> � -- - - ,� 3 C�.�--- I ! — <br /> -� - --�7f . � � � - _ - <br /> __-�� - �-�.��.��..��� - <br /> - �--- - . ,� . : __ __� __ <br /> -� ---- : ---;:--- , - <br /> : -� ;, <br /> - -� �. µ <br /> TOTAL <br /> � y�p�- ���-_'-_ _- <br /> REAtARKS: . _ ��^�'�- - - ..../J/ / _ --- <br /> ._-- _ _ _ - . -. �' _-__ <br /> _ �C __._. .. - -.__- <br /> �,slrC��y`�i.-�:^�'=7-�--_ - '� <br />