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"APPL:' I 9 S62 APPLICATION FOR SERViCE 3ERVICE � 2 ]2 <br /> N��qJ—�� CITY OF EVERETT WATER DEPT. ORGER � <br /> � FIXED � � P ���� <br /> � DEPOSITS �(j�.�0 W.oO. <br /> SERVICEfa��oon[ae>�/u� �� ,L�� OLK. LOT PDD/.._ <br /> OWNER— _ _ CONTRACTO �f ��r' � <br /> 3L `✓ F�AT o�3�� <br /> INSTAL � !� SERVICE � -t �e <br /> I HEREBY APPLY FOR THE USE OF WATER IN �CCORDAItl�E WITH THE <br /> ONDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> OR AS S�ME MAY BE MEREAFTER CIIANGED. e�cNeo: X — <br /> MATEfiUL6 �' IN. 1 IN. � 2 IN. � PpiCE AMOUNT <br /> _ PIPE , COPPEF•-,GALV.•- STEEL ' _I � ,� p�� <br /> CORPORATION�� / <br /> � CURB COCK ,j�-0T� _ L I <br /> SERVICE BOa � PLASTIG - C 1 ! I I � � <br /> METER VALVE <br /> METER No. TYPE: I ;f � <br /> METER BOX CONCRETE SMALL LARGE � I I <br /> � � � -i - - ��9 <br /> - �� - __� �� � <br /> - -� � <br /> � i <br /> - _- - ��- - � <br /> � � � <br /> � ON ���f <br /> DATE INSTALLED: I ❑=�OFF ;� '' � SUB TOTAL -/y /O <br /> �� '�_ � i <br /> CODE I LABOR AND EpU1PMENT RENTAL I HOURS RATE <br /> I ---� 3.: c��� ,.?/ ��l' <br /> ' _ ._ � _ �i , <br /> ' —�-�— __!'��,2� <br /> — — -- I <br /> I <br /> --�-�� `1 -- - - I-�_ i� � I,'�C' <br /> _ I I I�p <br /> TOTAL p�J � <br /> REAIARKS: � <br /> _ i ,�P L.! _—_ ---_ <br /> �/C��[T".- _'__ —_'!__—____'_. _ —._ _ '_--- ___ �_'_' <br /> / <br />