Laserfiche WebLink
APPL. �v��� APPLICATION POR oERVICE <br />No. <br />_ic,�, �, CITY OF EVERETT Wp.TER DEPT. <br />(� FIXEO <br />�� �D, F-,� <br />� DEPOSIT 5 <br />__ � , <br />�� � i , <br />r - <br />SERVICE (BY ADDnESfi)--' � � �/ '-,\ � �'�v pLK._� <br />. i'''///}��/' <br />OWNER�--_ _— ___CONTRACTOR�! <br />�/// ` FLAT �\ <br />INSTALL�.METERED SERVICE. _-__ <br />� <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE �` �� <br />ORDINANCES AND POLICIES OF TIiE WATER DEPARTMENT NOW E%ISTING � <br />OR AS SAME MAY BE HEREAFTER CNANGED. slGUEo:X_� <br />' L' <br />MATERIALS I�S IN.I ��N. I 2 IN. I <br />PIPE G9pPFj: -- GALV. -- STEEL <br />CORPORATION <br />CURB COCK OT <br />SERVICE BOX PLASTIC -- C 1 � <br />METER VALVL' c <br />METER No. TY'PE: I � <br />METER 00X_ CONCRE'f'c _ SMALL LAFGE` <br />- - �''�-� <br />� �. <br />DATE INSTALLED: r f. - 1;7 ,�, S'� �: FF <br />COOE I LIBOR AND EOUIPMENf RENTnL <br />Y%1 � <br />SERVICE N� 7 � Q <br />ORDER <br />�i,; ,, �:; <br />DATE'�;.'___ �'�- __ 19 -_ <br />N �� i.�,� �. i, ���,,i. <br />�� - ^\��?�" <br />..C-C..[�i' <br />PPICE l.�AOUNT <br />-� , /!/. <br />SUBITOTAL � Q����', <br />I U h-� ' <br />HOlIRS RATE � <br />�—L— ___�� I— .__ <br />� !� i <br />I'—�-- —'- - <br />I I ' <br />� ��(--�--- <br />TOTAL <br />EMARKS '�/ ,'� 1 ", � "/ ' :) I ( I '_; �I � i � l . I ! � <br />__'_ —_"_—}— '"_ _"—_ __— _ "._. ._ <br />. _ �I � � /"' / . <br />. ..J.C_�j� � '•� .. . ) � l' (. ��_ .... <br />'_"._ .—'-_. _ .-____ ... __ __� _ �. . _ __ ._ ..__.—_—!.____.. <br />