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. �I' '4PPL• �iZ� °'�� -APPLIC.' TIUN FOR SERVICE <br />i N� ��- CITY pF EYERETT WATER DEPT. <br />� �FIXED <br />n CaU <br />� � DEPOS S� .L.��� A <br />i � <br />i ��� ''i� <br />; SERVICE (ev �uoRess). L� '�.���Ct�.i�_[_7 _ V�% BLK. LOT. <br />IOWP'ER�Q�' _}__ �L��.,,L�{�_ __ _CONTRACTOR_ <br />� y� � � LAT j <br />I �NSTALL�11^�ETFED SERVICE—_ _ _ _ <br />I 1 HEREBY APPLf��OR THE USE OF WATER IN ACCORDANCE WITH THE / <br />I ORDINANCES ANO POLICIES OF THE WATER DEPARTAfEA'i NOW E%ISTING , <br />OR AS SAME MAY UE HEREAF7ER CHANGED. sicNeo:X_. <br />I — <br />� lAATERIALG � j� IN. 1'IN. I 2 IN. � �, <br />PIPi: <br />GORPORATION <br />CURB COCKi OT <br />SEFVICE BOX <br />R r GALV. -• S7EEL <br />PLASTIG ••( G <br />� METER VALVE <br />�—_—__ <br />� METER No. __� <br />� METER BOX CONCRETE <br />,.i �r...'.��i._e <br />TL��r N fc <br />�— <br />I DATE INS':.1LLED: <br />COOE <br />TYPE: .__ ...__ I '� <br />SMALL I.ARGE <br />7'_u � `�! ^ `� ,,�, I' <br />��. % 7 i . <br />---- �trw �l:_c,',: : <br />:i— �—�� <br />� �. � � ON <br />� � /' �� � � OFF <br />L�BOR AND EOUIPMENfRENTAL <br />SERVICE NO ZZ�6 <br />ORDER <br />DATE�(��— __19_i_yL <br />l J. U. <br />PRICE <br />SUB TOTAL <br />HOlIRS � RATC <br />� � r�0 i—� �— ---i ` — <br />, f..----- —i —� <br />�� ���� _ . � <br />I I - �� �`'" --�-L ��-- <br />I - I - <br />, ! -- _ =o-r= - -- -!- <br />TOTAL <br />REMARKS: <br />AMOUNT <br />