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APPL.. _� �OS � O ARPLICATION FOR SERVICE <br />No. <br />�?c��i,� CITY OF EVERETT WATER DEPT. <br />� FIXED <br />� DEf'OSIT S �/�� � �j <br />e <br />SERVI7'n� �er nooq¢ggl—�' �/.� � �t {-�,��^'J1i, ��Z BLK. LOT_ <br />� t�A.a.'J T� lI �y �-(�C/�� AiL.q-);rt, �HtI'� <br />OWNER— `-''�•-�-.vi �" 2-. F�g • � CONTRACT��� <br />INSTAL 1 �� 1� /35i/j� <br />A�ETERED SERV;CC_ <br />I HEqEBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARiMENT NOW E%ISTING ti_ �� 7z✓ <br />OR AS SAME MAY BE HEREAFTER CHANGED. �' <br />BIGNED: X <br />M�TERIALS ii IN. t IN. � �2 IN. Ij-- � <br />P�PE COPPER - GALV. •- STEEL I I I I <br />CORPORATION <br />CURB GOCK OT <br />SERVICE BOX PLASTIC -• C I <br />ME7ER VALVE <br />METER No. S��%,3 - �7CC�5TYPE: %fyy�j I ;b <br />METER BOX CONCRETE SMALL LARGE <br />s-5'xxxi6 5Fc-,� �,e:v y-SxS�r� stblyr.Gai pl;'�,�'; <br />��Hx6�x/c� •� „ %ig �+,v-5»rr�PSf�s� <br />='7 - �'ttt7a�s2��a�� PU."3 i3 <br />�' Z� - 5s�;. ,C�[y�Lx;�G D '' �7/� <br />�L� Z/- �Aii�i7nOJ. �''3nv1�. � � <br />.7c C �Cltl�7�/�/�J/� %/(,'7�.<' C�; �j <br />- - , I ON <br />DATE INSTALLED: ' - � - " �,�'% � OFP <br />CO�E I LABOR AND EQUIPMENT RENTAL <br />� � . <br />SERVICE'Y� � 2 � Q <br />ORDER <br />DATH �� ` ��� 19l,/lI <br />W. O. <br />V <br />- �(:2_LI_.��_ <br />��� <br />PqICE � AMOL <br />SUB TOTAL <br />MOURB ' RATE <br />TOTAL <br />REMARKS: <br />�V .��� <br />