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APP�• Z� D�� APPLICATION FOR SERVIC@ SERVICE N° 1 765 <br />No. ORDER <br />CITY OF EVERET7 WATER DEPT. <br />IXED DATE � —�� ___�g�.3 <br />� �c' <br />, � DEPOSI7 �� � - <br />W. O. <br />� No._ !� <br />�/Y-'� � �% •- .i �v.2/oc C� <br />� SERVICE (BYADDRE63)_.__ - _���L`p�K �_LOT_LU A/D�D._�_�- � C <br />i Q:VNER�[/9�LCL �O�l ' Y _ CONTRACTOR��cGA__UL�E' /�,!/SU7L �_PpJ <br />�s <br />I INSTAL� FLA�� SERVICF 3S�--I ����T'Lv-`��%�/'UiYG� <br />— YL'� �.��raTF- <br />� I HEREBY APP:Y FOR THE USE OF WATER IN ACCORDANCE WI7H TNE <br />� OR�AS�SAME MAY BELIHEREAF7ER CHANGED,DEPARTMENT NOW E%IS71NG /v /�/ '7 ��� /�/�`� <br />SIGNED: X � L �J �` <br />1 <br />MATERIALS �� <br />� � ItL I t IN. I 2 IN. I I I I PPICE �I AM Ni <br />I P��'E COPPE� •- GALV. - STEEL <br />� CORPORATION <br />� �R���_ <br />LSERVICE BOX� PLASTIC _ C � -----__— <br />I METER VAWE <br />ETERNo._'_. —_—_—_ _—TVPE:—___. _I .—_ <br />— --_'__ _ ��_ <br />� METER BOX CONCRETE SMALL LARGE <br />� --- ------ <br />I DA'iE INSTALLED: <br />cOD� �'�' <br />REMARKS: <br />UN <br />UBOR AND EOUIPMENf R[NTAL <br />f o • —�— <br />t� 2�[J� ._�.S_ _ �� � <br />J � . <br />�L� �C'/�!'�cP C�'CN%vo-o /OLr <br />+ -_ _. . ___._..--.___—_— __—_ _ <br />�_—__._____—_ _ _ _ <br />SUB TOTAL <br />HOURS � RAT[ <br />TOTAL <br />N <br />