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APPL. ^ /_ C/G CITY OF EVERETT SERVICE <br /> No. oti�� � ORDER ^, <br /> _ APPLICATION FOR WATER SERVICE IN�I�w _ �5./z ]� <br /> FIXED DATE_�_�rt��L18 <br /> � G <br /> t �`I oErotiT s �� � N o. <br /> _ , <br /> SERVICE I�rwoD�u�)�O �. ��BLK._ LOT�_I�ADD. <br /> OWNER�11 G�C6 - CONTRACTOR ) t'r K%(�1t�fQ��-����� <br /> /���� 11� <br /> INSTALLI�METERED SERVICE <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> OROINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EKISTING � �� -� <br /> OR AS SAME MAY BE HEREAFTER CHANGED. slcHeo: X-_ <br /> MHTERIAL6 Si IN. 1 IN. � 2 IN. I I PR��E AMOUNT <br /> PIPE� '�_ � I I � - <br /> I-- <br /> CORPORATION � � _�—� <br /> CURB COCK OT I <br /> SERVICE BOX LASTIC C I _I _ <br /> METER VALVE <br /> METER No. TYPE: I �5 <br /> METER BO% CONCRETE SMALL LARGE <br /> s � a —I <br /> , E ` . i—i— — — <br /> r/�77�P,5A4�c� - _� w a . ---� --� — --- <br /> --�— —� — <br /> ,� �� I I� ! <br /> p I �{ ON /J/J <br /> DATE INSTALLED: d�^ �3I'(„)� �� OFF �.�it.� SUB TOTAL <br /> CODE I LABOp AND EQUIPMENTRENTAL HOURS RATE <br /> � �1. Q�� _"—�� <br /> i � i, i�,� _�I� -- <br /> � �-�0�9 -�'-(- - <br /> � <br /> �- i�- --- <br /> � -- -- ----- -� - <br /> i _ __-}_- <br /> TOTAL <br /> REMARKS: <br />