Laserfiche WebLink
APPL. .?r D� 3 ,p APPLI�ATION F'OR SERVICE <br />No. <br />�= b,�, � G CITY OF EVERETT WATER DEPT. <br />�� FIXED <br />� <br />� DEP091T g!,�-�--'�, - <br />� o �y <br />1-� � / % I <br />i �i-� <br />SERVICE (BY ADORE95) 'X� ���'�� ��6�K�' ��, <br />� %7-�-r i ' `>' + . <br />OWNER �� _CONTRACTOR�� ' <br />� �7�J �� FLAT <br />:NSTALL,�_µGTiRED GERVICF _ __ _ <br />I HEREBY APPLY FOR 7HE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AI�D POLICIES OI� 7HE WATER OEPARTMENT N01Y EXISTI;IG �1/� <br />OR AS SAME MAY BE HEREAFlER CHANGED, s�cNeo: X___Ll <br />M�TERIALS j� IN. � 1 IN. � 2 IN. � <br />P�PE ( OC PPER.-- GALV. •• STEcL � X� I I�I <br />�_�' -. <br />_CORPORATION f,�� S�� <br />� F� r <br />CUR� COCK ��OT� <br />� -- <br />SERVICE BOX LASTIC)-- C I <br />METER VALVE <br />METER No. _ ' TYPE: I ;5 <br />METER BO% GONCRETE SMALL LARGE <br />� ON <br />DATE IN3TALLED: /OFF <br />�i - —/ >' Q <br />i <br />GODE I LABOR AND EOUIPt.1ENT RENTAL <br />I�/i . 4�../�r _-_ _—__.—'_ _—_. <br />O ! <br />REMARKS: <br />. � f) ' `: n ! --__ <br />_.,. ��:.__._.._ _.___' _.__ . <br />SERVICE N� g g � <br />ORDER_ <br />'�?�` � �� i 4=� <br />DATE=`_j% " <br />W. O. <br />/- <br />� <br />—ADD. <br />�. i1..r'..:� l:L'. <br />PHICE � AMOUNT <br />SUB TOTAL <br />HOURS I pATE <br />� � <br />.j .' <br />