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,ppL,���� -7 APPLICAT,OON FOR SERVICE SERVICE N^ ?245 <br />aG. '��� •1 �-�� �r OR�ER <br />��,���, a,Z 1q� CITY OF EVERETT WATER DEPT. � �p .7 <br />� FIXED DATE � —19� <br />� DEPOSIT < <'c, PN, s�"II�Tto Avo��ZIG-�'lo wt+iu� Noo. ---- <br />S 7Cr:�). C.-:r�: zSY WnCcx- UcPT. I <br />SERVICE (eY ADORess)—LLDW--�—"����'� � BLI(. I_0T1 � ADD�� <br />. � A �I����=E � p'ae�; — <br />� OWNER - � � CCNTRACTOR --- <br />LA <br />INSTAL � RED SERVICE_ ----� � -- ° �-- <br />i I HERE�': A�FOR THE USE OF WATER IN ACCORDANCE WITH THE / � <br />� ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING ` ' i <br />�' OR AS SAME MAY BE HEREAFTER CHANGED. s��r+eo: X?�=�' —= �� -�_ ---- <br />' 1.IATERIALS �h IN.I 1 IN.'� DIN. I I P CE�.• N OONT <br />' PIPE OPPEH -- GALV. -- STEEL I I.�,I I�I I__�� / <br />CORPORATION <br />!' �ao ^ ^�( <br />SERVICE BOX� <br />METER VALVE <br />METER No. � <br />METER BOX <br />�i � � I <br />L— I —I <br />PLASTIC -- C I I <br />� <br />��f TYPE: � 3S _ ' � <br />INCR� SMALL ��LARGE� � <br />� CN <br />DATE W57ALLED: i ���. � V� � OFF <br />if - <br />CODE I LP00R ANO EQUIPMEN�f RENTAL <br />J % �1 � t � ' <br />SUB TOTAL <br />I HOURS � RATH <br />• {''��l � T I . _—_- <br />I G-1�.NZ� - � ---- <br />_ _ ��/�� i C,. ,�ii�lr.� I <br />� C� � �- � '- - - <br />I -- " �.i' > ' - -- <br />I -- ---- —T�'=5----- -��- — -- <br />-I ---- —� - –�—'--�--, I ��r <br />TOTAL <br />I REMARKS: <br />I_-"' _ _____— _ <br />