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APrL. ^ ' MyQ CITV OF EVERETT BERVIGE <br /> No, �/��7 AppUCATION FOR WATER SEflVICE ORDER n'�r 7 6� <br /> C�-ui (. L 7 I`I f7 <br /> ❑ATE_ �Q <br /> � F'1%FD � <br /> W.O. <br /> � Lrr051T i l. u _ / � // No. -- <br /> 1-717 r�O�.�C2.7 'o_ lu/' <br /> lERVICE c�YAOD11p�1 I-, BLK._ _LOT ADD. �� 1 <br /> OWNE�+�L (.J��� CONTRACTOR �` " <br /> /� FLAT <br /> IN57AL��F R D ER"IGE -- <br /> I NEREBY APPLY FOR THE SE OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%�SiING <br /> OR AS SRME ''�Y BE IIEREAFTER CH6NGE�. •ICN[�: -- -- - - ---- -------- <br /> MATERIALf W IN. 1 IN. � Y IN. � � CE AMOUNT <br /> ���E PLRST ICy ,eerrew- -.. , � ' <br /> CORPORATION F�j�j�� � - <br /> CURS COCK OT I <br /> fERVICE BO% PLASTIC -- C I I , <br /> I <br /> METER VALVE nI _ --- <br /> METER No. 7GJ�_I TYPE:�A�D4£�Y `` _ ___ _-- <br /> ETER BO% GONGR�TC ��N'��-�t �E -- -- <br /> l�n�A�tv'.L��� ��-�W�� -- i——��— <br /> � -- � �� _ <br /> ��� - - --- �- ---- - -- <br /> �=' E�T ST�EfN E2..� i �-i- <br /> DATE INSTALLED: �rJ "V�' (J8 I � OFF �� , IRU� SUB TOTAL <br /> COD[ I LABOq AND EpUIPMEN�fRENTAL MOURS RATE <br /> �i � ( . f�L� <br /> a� �_��e��.�-,-�►., , � _ - <br /> i __��-i�g � - -- <br /> � --_- �so� I � — <br /> i -- �-- <br /> I ---�-- <br /> i <br /> TOTAL <br /> REMARKS: �i��TJI S �'�I'ICt._. C/I' �`^C�l��l� — <br /> � <br /> i <br /> I <br />