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HPPL, JT�`�a APPLICATION FOR SERVICE SERVICE y° �$$] <br />No. � rl- ' ORDER <br />CITY QF EVERETT WATER GEPT. I <br />�FIXED DATE ` —� _�9� <br />� DEPOSIT ��� �'� C� . � W. O. <br />�i:,, _7� cC•'-=�! No.__ _ <br />2—�-l-lo Nc� r�a �� U F_ :z�.z5,z� �� �:�1� <br />SERVICE (BV ADDpEss)_ �_ � �LICSS��LOT—_ACD.__ <br />C � ���p�odFtSCarZr�����1n;U1n 1� � 4 /� _� <br />OWNER —+C��+�_��`J�r CG. _CONTRACTOR—I���"_i1��=�CU_-L_I�SS�C. <br />3�,e�1 r�r <br />INSTALL . ML'TERED uERVICE— —. '�—�-T " <br />I HERE9Y APpLY FOR THE USE OF WATER IN ACCORDANCE WITH THE " ! �� <br />ORDINANCES AND POLIQFiS OF THE WAfER DEFP.RTMENT NOW E%ISTING �'� <br />OR AS SpME MAY BE HEREAFTER CHA'tlGED. sicneo: X.�6�_- _"_�`� ?l ��� r-L�_ <br />M.ITERIALS <br />PIPE <br />CORPOHATION <br />�CU�COC OT __ <br />SERVICE BOX PLASTIC -- C 1 <br />METER VALVE <br />tAETER No. � <br />METER BOX <br />7 / . .i _ <br />/ <br />PJ -%'c- �_ <br />DATCINSTALLED: J_�� <br />/ <br />cooe � � , <br />V. -- S7ECL <br />LAFGE <br />1 <br />� ON <br />I—I OFF <br />AND EQUIPMGNT RENTAL <br />IN. � 1 IN. � 2 IN. � �, <br />PHICfi-�((� �AMOUNT <br />TOTAL <br />HOUfiS � RqTE <br />.-��G-y'C� �_��-3�/ ---� �-- �� I <br />l-�l?�c�'�-���' � —.���3-- -------� - - �,-- � - <br />--�'--�--�"��`�;' � �.�� _�_1-��---------------!-%�--- --- <br />> � <br />___— __ �r.i__ �� I <br />— I � <br />_ TOTAL �� � I <br />REDAARKS: � ( � r_ � <br />_ _ __ �L,_ �- - - � r_r�b��J.,1_:_z/ __^��, �-,� , _` ��� ,�_ • <br />, <br />,� � � -,� , -- �---- - <br />__�i_,,_�,�7-__�9 -/,��c,�,�:,, <br />f <br />