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'�PPL' SERVICE <br /> No, a, � ro _ CITY OF EVERETT oreoen NO. 1� i,� <br /> APPLICATION FOR WATER SERVICE � <br /> � FIXED DATE �r���_lp� <br /> �DEPOBIT s �D W.O. <br /> No. <br /> 3ERVICE ��r�oo •> � Q�� / v'� v BLK._ LOTS�ADDL �'J���1 P[L.L.. <br /> '� �-S� <br /> OWNE� '� ._CON7RACTOR <br /> FL <br /> INSTAL � ETERED SERVICF <br /> I HEREOY APPLY FOR THE USE OF WATER IN ACCOFDANCE WITH THE / � <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMEN7 NOV/ E%ISTING �j „p <br /> OR 115 SAME MAY BE HEREAFTER CH�NGED. s�cr+eo: %��i,.-..e��-_� �--Ct��7 <br /> MATENI�l6 yilN. 11N. � = �N. I ' PpICE AMOUNT <br /> PIPE COPPER•-GALV.-•STEEL <br /> CORPORATION __ _� <br /> CURB COCK OT I <br /> SERVICE BOX PLASTIC – C I I I <br /> METER VALVE � <br /> MCTER No. TVPE: —�—� I af --� -- -- — <br /> METER BOX CONCRETE SMALL LARGE <br /> —_ _--� — — <br /> I <br /> � <br /> __I _ _ <br /> ' __I _ <br /> I I <br /> �ON <br /> DATE INSTALLED: ��r ?/.p/ I � OFF SUB TOTAL <br /> Ob <br /> COOE � LABOP AHO EOUIPMENt PENTAL I HOUN4 PATE <br /> I` --- ,J .A,GTd� _ �_ <br /> I � <br /> --I —���--- -- -- I_ — --- — <br /> � ��I - I-- <br /> _ �� __ _� _ <br /> TOTAL <br /> REMARKS: <br />