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/1 ; :.� / h. ��.�5<,...� 5 rs �� <br /> NoPL �//�/ ' '' CITY OF EVERETT � onoenE N° 6 9 6 3 <br /> .4PPLICATION FOR WATER SERVICE ��-7"�, <br /> fd FIXEO DATE� �� —10.1(1 <br /> �P GD°�' <br /> ,� oerosir s w.o. <br /> ❑ ND._ <br /> SERVICE (w wDDeu�)_ G�� ! — S� • �^ � SE-_BLK.. LOT ADD. <br /> OWN[�jp(/%�^-' � � 'L��CX1rnN7RACTOR <br /> � 7� FLAT � <br /> INBTAL METERED SERVIGE_� L� �7�� ^��- � <br /> I NEREBY APPLY FOR THE USE OF WA7ER IN ACCORDANCE WITH THE /J <br /> ORUIN�NCES AND POLICIES OF THE WRTER DEPARTMENT NOW E%ISTING {'� —L�p ___ <br /> OR �5 SAME MAY BE MEREAFTER CHANGED. •�cr�co: X 1K F�4--�, <br /> M�T[RULt X IN. 1 IN. � 2 IN. � � PRICE �MOUNT <br /> �_ —_-- �� <br /> PIPE (:OPPER-• GALV.--STEEL <br /> CORPORATION _ <br /> CURB COCK OT � <br /> SERVICE BO% PLASTIC •• C I I <br /> METER VALVE <br /> METER No. -iVPE: I ?S <br /> METER BOX CONGRETE SMALL LARGE <br /> _ _I___— _ <br /> — _ — ___I -I_._ <br /> i I I <br /> I <br /> . __i �I_'I— _ _ <br /> I <br /> _ —__I � _ <br /> 1 _I_ I_ <br /> . ^`/ ---i— I —i � <br /> ON I <br /> DATE INSTALLED: /� �_��� I � OFF SUB TOTAL <br /> L <br /> COOE I LABOR ANDEOUIPMEN(RENTAL HOURS qATE <br /> _'_J_I �6 ��� '�� V I _ _ I _ <br /> I I <br /> I I _ <br /> i _ _ - �- _- <br /> I - - I <br /> �i ___ _ <br /> I <br /> TOTAL <br /> �EMARKS: - ��i "7��j ' L) _ __ <br /> / <br />