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r��. 2��S '� A�PLICATION �OR SERVICB <br />!o. <br />�,� CITIf OF EVERETT WATER DEPT. <br />�"'�_" <br />�� ronr s � <br />8[RVIC[ t�r wooem <br />OWNER �� <br />/Z � / `� �r1t <br />n .� <br />s�nviciN� � ?�rJ <br />OR�ER <br />DATE�— ��--__1 DZL <br />r <br />i XEREBY AP�L1' FOR iHE US[ OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND �OLICIES OF TME WATEII DLPARTMENT NOW El(ISTING � � <br />OR AS S�ME MAY BE M[REAFfEfl CNANGED. eicneo`7G� <br />MAT[111AU �' IN. 1 IN. I 11N, <br />PIPE COPPEp - GALV. •• STEEL �(�� <br />CORPORATION ^C, �+,(� I � <br />GURB COGK OT I <br />SERVICE �OX PLASTIC -- C I � <br />MEYER VALVfi <br />_MCTER No. �j`.j �� � TYPE: <br />M[TER sOX CONCR-ET[ ��_'" � a� <br />�..-*r. <br />LARGE � <br />� <br />� ON <br />DATE INSTALLED: �FF <br />7-is'-7/ <br />CODE I LABOR ANO EQUIPMENf RENTAL <br />i <br />_.—�'-�e.,�-r(1-- <br />--�--- - <br />i <br />REMARKS: <br />AMOUNT <br />9 /z <br />,� O,j <br />.S / 5 <br />�3 Z= <br />� 3/ <br />2 Z/ <br />SUB TOTAL GG o 7 <br />HOUNS RATE <br />u �'—'� 2 v ?i <br />TOTAL II �� <br />7 <br />