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APPL. No. (X � YJ f5 <br />k�/ <br />FIXED - J <br />DEPOSITS 1�- <br />SERVICE (Br ADDREBS) <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />I HEREBY APPLY FOR THE USE OF WATER IH�ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGNED: X.. <br />SERVICE ORDER N_o - - 6541 <br />DATE�� 1 B� <br />W. O. <br />--A <br />PIPE 3606670 COPPER -- GALV. -• STEEL <br />R IN. <br />1 IN. I X IN. <br />PRICE <br />AMOUNT <br />ORP Z-1 <br />1Coj <br />I <br />_ <br />— <br />o.►w.-..ew -OT#(6 5dJi Sp W,1'e-. <br />SERVICE BOX PLASTIC •• C 1 <br />METER VALVE/ <br />'7��,,','�• ,� <br />METE . 360��Y <br />METER BOX d��CtSNCRET -7 SMALL LARGE <br />I <br />Ago <br />w '-- 3 loot/ 6 5 Y <br />/ I <br />n s �rvlce O o <br />S�tl �'10k110W Prerenti tChnt>r�— O1 C1Lf <br />SLE It IuaroelrjGo3351/ 7/ <br />I <br />— <br />_ SaC s h,kNN( � o-, <br />DATE INSTALLED: 2— — �d <br />ON <br />I KOOFF <br />SUB TOTAL <br />CODE LABOR AND EOUIPMENr RENTAL <br />_ <br />HOURS <br />rTp�k�I Co <br />RATE <br />� <br />-- - -- <br />- --- - -- — <br />Z13� <br />35o S I 6 <br />-- <br />- <br />I <br />TOTAL <br />