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B <br />No. A A <br />- No. (�l�CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />❑ FIXED <br />DEPOSIT t ,�A izi <br />SERVICE (By ADDREE <br />2/ Elf <br />OWNER -I— CONTRACTOR_INSTAL " _ 6_ <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. <br />_ SIGNED: X ._ <br />MATERIALS <br />_ Yi IN. I IN.I 2 IN. <br />PIPE + 1�COPPER -- GALV. -- STEEL <br />CORPORATION <br />CURB COCK OT <br />SERVICE BOX PLASTIC -- C I <br />METER VALVE <br />METER No. %-/ h TYPEi�A�l R <br />METER BOX CONCRETE—&,ZG SM ALyLS LARGE <br />DA'fE INSTALLED: Aiy <br />CODE I / <br />REMARKS: <br />IZj�ON <br />J OFF <br />LADOR AND EQUIPMENT RENTAL <br />0 <br />SERVICE <br />ORDERR�� NO/. i�( CI 4z I, <br />DAT <br />W. 0. / <br />No. <br />�D_LOT— ADD. <br />981 <br />.199 <br />1_ I PRICE If AMOUNT <br />SUB TOTAL <br />HOURS RATE <br />TOTA <br />H -1 <br />In 2 <br />rn <br />C O <br />Fri <br />-� c <br />O 3 <br />rn <br />i -z-I <br />m <br />o z <br />C <br />r 2 <br />—1 <br />j TI <br />na <br />3 <br />1 rn <br />2 <br />m I-• <br />N <br />O <br />C� I" <br />C N <br />3 N <br />m <br />z r. <br />A m <br />m <br />a <br />