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-w� � <br /> AF^L. �o�,���7 . AP.�iICATION FOR SERVICE sErxvice [�Jo T �122 <br /> N�. � CITY OF EVERETT WATER DEPT. ORDER /` <br /> �XED DA' E��-�_19_�U <br /> � �� p <br /> �DEPOSIT S 2 " �'.00. <br /> � _ �� r � �y�,G� � <br /> �--�__��'c _� �- Lz' /"''�G/�L�hD <br /> $ERVICE (BY ADDXE88)_� -r BLK. LOT ADD.�y�Yr� ;�'�e`� <br /> � <br /> OWNER_ � G_,�tii .St,C�S� CONTFACTOR�2-�_�'D 4C <br /> � I� FLAT J'LC i �� _�E'�.tiE <br /> INSTAL ��.METERED SERVICF __ __ <br /> 1 HEREBY APPLY FOR THE USE � F WATER IL ACCORDANCE WI7H THE 7� /�y/� <br /> ORDINANCES AND POLICIES OF TXE WA;ER D4Yi�RTMEN7 �OW E%ISTING � � ,��+,�' ��/. -J%�/-,F� � . <br /> OR AS SAME MAY BE HEREAFTER CHANGED, e�crveo:X � <br /> MATHRIALS � IN.( 1 IN. � 2 IN. � I I _^RIC� AAIOiNT <br /> PIPE COPPEF.•- GALV.--STEEL <br /> CORPORATION I I I <br /> CURB COCK OT I_ I I <br /> SERVICE BOX PLASTIC •• C I I I I <br /> METER VALVE <br /> METER No. TYPE: I >S __ _ __ _ � <br /> METER BOX GONCRETE SMALL LFRGE _ _ �_ _ <br /> I� I <br /> I <br /> I I �I_ <br /> —�'—I — — — I <br /> __' � � �— �- <br /> �I I I <br /> � ON I <br /> DATE INSTALLED: � OFF SUB TOTAL <br /> L <br /> COD[ i LABOR AN�EOUIPAtENiRENTAL i HOURS RATE � <br /> ' I �I I <br /> --� � ��, -- <br /> - -------- �- -, � <br /> --- - � - ;; I <br /> --� I� I <br /> _ i - - - --�- ��_I__ <br /> Q I � � TOTAL II I <br /> REh7AR1C5: ' , . ..— . , r �� — � —_ <br /> ' . - - — �— — ____. . � r._ �r-- <br /> -- - ��1-�-- -=- �- -- <br />