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MPL. .� ^ p7��� APPLICATION FOR SERVICE sERVIGlN� 1623 <br /> No: ..�/�� OFtDER <br /> CITY OF EVERE7T WATER DEP7". <br /> � FlXED 0� DATE � _ IO- 7Z18-._ <br /> /1 / W' O. <br /> ❑ ��'x �G� — No. ___— <br /> seRv�c[ ��r �oonu�n_�8o3- �C�-�'�'t+'"�'''-�'-« ��' BLK. L07_57�J ADD.UIILL��ClSJ <br /> OWNEI�yJ.L����25�-�� CONTRACTOR_L1sLL�,�"� CO• <br /> ' r•ur <br /> INSTALL�r__�CE_-- - <br /> 1 HCREBY APPLY FOR TNE USE OF WATER IN �CCORDANCE WITH iHE Q��n r � � <br /> ORDINANCES ANU POI.ICIES OF THE WATER D[PARTMENT HOW EAISTING Y_d !La-�C� <br /> OR AS SAME NAY BE XEREAfTER CNANGED. s�cneo: X..--._ —___ <br /> NAT[RIAI� � IN. 1 IN. 2 IN. � PRICE AMOUNT <br /> I � <br /> _ PIPE COPPER-GALV.••STEEL I _ <br /> CORPORATION <br /> CURB COCK OT ( <br /> SFRVICE �OX PLABTIC -• C I I <br /> MfiTER VALVfi __ __ _ <br /> _M[TER No. _ TYPE: _1 >S _1_ _ _ _ <br /> MlrTER BOX CONCRETE BMALL LANGE <br /> � -____ — _ � —i� — ___ — _ <br /> — _—�—' �I — _— — ____- <br /> --- -- — I—� —I�� � -- -- — <br /> � ON <br /> DATE INSTALLED: � OFF SUB TOTAL <br /> CODE I LAOUR AND EQUIPMEN'f RENTAL I NOURS PME <br /> I I <br /> ._—I _' . — _—__I—__ __--_ <br /> I --'_ _—_..—'.—__._—_ i __— _ _— — —___ <br /> _—_, _ __ �'_ __. .__ _ <br /> __—___'_' __ — .. "_--_ _— -- <br /> —_—I—_. __—_.__—'____—'—_ I _ — _ —_ _ <br /> "__''__ _ _____—___—_ ____ '——'.�— '_. _—_ . _ <br /> _—i � �� I I <br /> I TOTAL <br /> RE�tARKS: � � , . . ' , _ . , � . . . _..� <br /> ,�y._z�'_ , - <br /> -- ----- -- ---- -- --- -----�-- -----.��- <br />