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A�'P�• 2 0 3O C� APPLICATION FOR SERVICE seRvice �° � 5 ,rj <br /> riS. <br /> ^: .3c'j� � CITY�O� EVERE7T WATER DEPT. �ROE f�;. � /, <br /> �- FIXED DATE__�_�'.�.��._19�_ <br /> � DEPOSIT / � ��-��� \N.p, - <br /> 5 c J. - No.—.' _' _ <br /> _.� ' . <br /> SERVICE (er"wooaess) � ���` ���-L�"�"�'` ^ �=_BLI�. LOT_��' aDb-'��"�'z""��-�`�� <br /> OWNER.��Lt--�l. ._.4_�% �' .y�-G_o-lZ_''_--_ . <br /> ' �� CONTRAC70R <br /> � P�- <br /> INSTALL-�''�r METERED SER\tCE----.- <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE . <br /> ORDINANLES AND POLIGES OF THE WATER DEPARTMENT NOW E%ISTING � � ��jL� <br /> OR AS SAME MAY BE HEflEAFTER CHANGED. slGrvso: Xf _ L"-=�-'-�`�_'_____ <br /> MATERIALS I �,iIN. IIN. 1=N. 1 � I Pp�CE/ AMOU�R <br /> I <br /> PIPE COPPEI.�-- GALV.�--STF_EL �5/I _�_��— -- �`p , �n <br /> CORPORATION __ � I II �I� <br /> _ CUR� COCK OT I —�I I <br /> _SERVICE BOX PLASTIG -- C 1 I I <br /> METER VALVE 3� � <br /> -��;T- 7t�i�+-�L,� I -- - - <br /> METER No. �cv TYPE� �� �. �� I � ��� <br /> � � � —�—_ ___—. - <br /> METER BOX CONCRETE MACCi ARGE �' _I_ � � <br /> _ -1 ! --- � --���--`' <br /> ��`� , __ � �-I- �----.Ll� <br /> - - - �i -► �--i <br /> - - ' i�'� ' <br /> ON <br /> DATE INSTALLED:S� /? V � �!OFF ' SUB TOTAL /// •�� <br /> f- <br /> CODE � � LABOR ANO EQUIPMLNTRENTAL � HOUPv RATE <br /> I ���.9� '� -J .- �-. <br /> I -- " -- — --------I�.� =�— I _ � ,` . — <br /> � � _ <br /> I.r�����V� —._ - - I J_ -�I j.j I?.. <br /> I I <br /> '__ ___ _I_ -__-'_-ii� I <br /> __—II _-_ -"--_— __ _.-_ _-____ _ -_ —II - i _' <br /> I I <br /> I��� TOTAL �� ?�� <br /> f'cM1 ARK : <br /> -- -__ _ _._' . ___ '-_.—. <br /> � -___.-__._._— _._. ._'_-_ _ <br /> __- <br /> , , r;�,; .:, � <br /> _ _ -- - --- __ _ _ - � ._ <br />