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APPL� '� �� / APPUCATION FOR SERVICE SERVICE No Zqgg <br /> No. oZ/ �'7�y ORDER <br /> CITY OF EVERETT WATER DEPT. ,,((�I �. �` �' �, <br /> �I%ED OATE_��Ry��191� <br /> � <br /> � � DEPOSIT f ��JD �� No�_ — <br /> ; SERVICE lav wooaus) .��0�1- u!I.1`��� -. BLK. LOT�ADJ.�V_.��-GT� <br /> . OWNER�'�J v� A .GiLL�.1"1%L�2_��—CONTRAGTOR S-14LVIS _— <br /> I INSTALL /� METERED 6ERVICE --� - <br /> I I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE _ <br /> � ORDINAN[ES AND POLICIES OF THE WATER DEPAPTMENT NOW EXISTIIiG � _ <br /> OR AS S�ME MAY BE HERE�FTER CHANGED. sicH[o: X_ <br /> MAl'ERIALe �/i IN. I IN. � 2 I . i I P ICE AMOUNT <br /> � plpE COPPER GALV}•STEEL � I I� _ <br /> I CORPORATION —�� . <br /> CURB COGK OT I II <br /> � SERVICE BO% PLAS7IC -- C I I � . <br /> _ � <br /> � METER VALVE __ __ (S�LC__, _ -- — -- --�— -- <br /> � METER No_S��'p TVPE:�,'�/a1�O� I�__ �_ --__ . —_ _ <br /> � METER BOX GONCRETE�. SMALL LARGE - __ I _ _ <br /> ? x � �C * �3� T�-,� .r����� � � ----�-- <br /> f--��fkoy Dory N%lPLE �►'x3n -_ � li — <br /> i.� �---- <br /> � 1�' Mi�T1R�Eu�ftCF„T, _I I _ <br /> (— a" G.i. 9�f � 5 -- <br /> i ------ -- � � �--� i— — <br /> �7 ON <br /> � DA7EINSTALLED: � �FF SUB TOTAL <br /> G_.�- � 7 <br /> CO�E � L�BOR ANDEOUIPMENfPENTAL I NOURS RATC <br /> j � —�o��---��_ <br /> � I _�fI v �G �_l� — - <br /> I I �} / / �-�--- -- <br /> i � �=l�z� -fl� ��F�-__�-J_ <br /> ii - - - -- - - - <br /> i i � -- <br /> i � --- --- - --- - ---�---- - <br /> i TOTAL <br /> IREMARKS: �:� .� J.,. ' . ._ — ____- _— _— <br /> —__' <br /> , . ._ _.—'.________--_ <br /> !____ , _".—__ _ ___— ___-- __ <br /> 4 <br />