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� NOP��( `�•�� APPLICATD�N FOR SER`/ICE SERVICE Nn Z426 <br />CITY OF EVERETT WATER DEPT. ORDER <br />i�FI%ED DATE.._/_(___19Z <br />O" � <br />:� OEP031T s yn O _ W. O. <br />i No. <br />�� o ✓'i �,/� / <br />�. SERVICE (BV ADORF�OI I ���• _,�*':[q� ) � � / � a— <br />i BLK.,e�,> LOT � ADO._1�-li�1�"�� <br />OWNEIL v1 1 -�— <br />'� a <br />i - � , '-'� �=L-- GONTRACTOR. <br />� INSTAL � � F� � �- - <br />�--��_FiETERED SERVICE <br />I 1 HEREBY APPLY FOR THE USE OF WA7ER IN Af.CORDANCE WITH THE <br />I ORDINANCES AND POLiCIES OF THE WATER DEPARTMENT NOW EX�STING /� <br />� OR AS SAME MAY BE HEREAFTER CHANGED. sicNeo:X.�'��[__ �• <br />�--_ <br />n1ATERIALB }i IN. 1 IN. � 2 IN. I I I PRICE <br />I iI AMOUNT <br />�'�PE COPPER r GALV. -• STEEL Z S"� <br />� CORPORATION <br />__ ��� <br />I �'___�R6 GOCK ; _ OT -- <br />� SERVICE BOX� �PLASTIC C I I <br />I �" <br />I � M� ETER_VALVE <br />1 — _ <br />I � ME7SR No. _____�___'TYPE: _ I �F <br />� � METER OOX CCNCRETE <br />i _ SMALL LARGE <br />�'—______ I <br />I � r'� � CO �?! � 7r i-f! ,1i 1� i � <br />7 <br />� ---- <br />I �ON <br />DATE INSTALLEO: � / . G - / � � OFF <br />i C' <br />' ��_I L�BOR AND CQUIPMEN! RENTAL <br />I1 I <br />__ • � '/Yl, <br />I I � n <br />REMARKS: <br />SUB TOTAL <br />I HOURS RATE <br />___�—I �Y�— <br />I l/ <br />I� <br />i/ <br />— �J <br />I <br />� <br />TOTAL <br />