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APPL. 2 l ECG <br />NO. G <br />❑ FIXED 6<1 <br />DEPOSIT s <br />SERVICE <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />OWNER —J'...4'[G��G� -- C <br />INSTAL, 3/�C METERED RVICE <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATEP DEPARTMENT. NOW LXISTING <br />_ uAMrcn <br />SERVICE <br />ORDER NO. <br />DAT���� <br />v <br />W. O. <br />LK._ LOTJ.�—A 1L <br />-OR— <br />SIGNED: XX�-�� <br />PIPE <br />CORPORATION— <br />MATERIALS <br />COPPER - GALV_- ST7EL <br />i'i IN. <br />I <br />IIN. 21N.1 <br />4— <br />PRICE I <br />AMOUNT <br />CURB COCK OT <br />SERVICE BOX <br />PLASTIC -_ C 1__ <br />_ _ <br />METER VALVE <br />--- <br />METER NO. <br />TYPE: <br />METER BOX CONCRETE SMALL LARGE <br />I <br />-- <br />I <br />-- <br />I <br />DATE INSTALLED: <br />/^ I ✓ 7 _— <br />V <br />ON <br />, OFF <br />SUB TOTAL <br />I� <br />LADOR AND EOUIPMENI RENTAL HOURS <br />SIt <br />41 <br />RATE <br />i <br />�- <br />TOTAL <br />REMARKS: <br />z <br />0 <br />mm <br />� m <br />N 2 <br />m <br />c o <br />t I O <br />El <br />CD C <br />O m <br />m <br />i <br />m_ <br />C <br />D <br />1 <br />m <br />on <br />=m <br />m.. <br />0 <br />o r <br />c-t m <br />C !n <br />N <br />m <br />�r <br />• m <br />n <br />