Laserfiche WebLink
APPL. <br /> No. �G33� , .. ' CITY OF EVERETT BERVICE <br /> APPLICATION FOR WATER SERVICE oROER N° 5106 <br /> � FI%ED � DATE_ n,�!r �p� <br /> � DEPOSIT �� v � � � �� <br /> W.O. <br /> No. <br /> EERVICE ��rwooeq��- �a� � —�1J }r�(l A� BLK._ LOT �� ADprJ�uLy`s���T <br /> OWN[ CONTRACTOR_� ���, <br /> 3 // LAT 1 <br /> INSTAL ED SERVIC <br /> 1 NEREBY APPLY FOR THE USE OF W�TER IH ACCUHDANCE WITH THE i�— <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING <br /> OR AS SAME MAY 9E HEREAFTER CHANGED. _ — � <br /> sieNeo: <br /> MATENI�LS �' IN. t IN. I IN. <br /> I I PHICE wMDUNT <br /> r�PE COPpER•- GALV.••STEEL LI <br /> CORPORATION . _—I� <br /> CURB COCK OT i � <br /> SERVICE BOX PLASTIC •- C I I -- - <br /> METER VALVE — . <br /> METER No. __ TVPE: —_-- .S -- ---- --�— -- -- <br /> METER BOX CONCRETE SMALL LARGE _ i -- <br /> — I�_L�I-- —_ <br /> --I —�7—i— — <br /> I <br /> _ � <br /> � I� <br /> � <br /> �J ON - <br /> DATE INSTA�LED:� U'��G��� OFF <br /> ❑ SUB TOTAL <br /> COO[ I LI180p AND EQUIPMEN!RENTAL <br /> IMOUp3 RATE <br /> I _ Ca,�yJ",R�1t�77_�--�— --- <br /> � ----�-��� -a� -- �--- --- <br /> _I _ _ -- -� - <br /> - � --{-- <br /> REMARKS: TOTAL <br />