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APPL. �1 ��/'� CITY OF EVERETT SERVICE �; ��C CJ <br /> No. °'� ORDER NO. � �� <br /> APPLICATION FOR WATER SERVICE /J�� � �Q,� <br /> FI%ED DATEL� ' � —��_ <br /> ❑ P! l� <br /> �' W. O. <br /> � DEP091T s �j� _ No.— <br /> � � SERVICE !er�oce[o� ���`� -�� BLK._ LOT 3�— • _� � <br /> OWN[ _--CONTRACTOR <br /> i <br /> INSTALL�S�-METERED SERVICE -- <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORD�NCE WITH THE � � ,��� /r/��'� <br /> ONDIN�N[ES �ND POLICIES OF THE WATER DEP�RTMENT NOW EXISTING s�eHeo: X ��+��--i--�=�- / <br /> OR AS SAME MAY BE HEREAFTER CHANGED. <br /> MATEfl1ALe li �N• 1iM• IZ �M' I � PRICE AMOUNT <br /> p�pE COPPER•- GALV.--STEEL _�� <br /> CORPORATION _ - <br /> — � <br /> CURB COCK OT I i I_ <br /> SERVICE BOX PLASTIC •• C I I I <br /> METER VALVE _ _____ <br /> METER No. --- 7YPE: _.I `S _ _ __ - ----- � <br /> METER BOX CONCRETE SMALL LARGE __I__ <br /> —i I <br /> �I — — <br /> — I <br /> �I I I <br /> ON <br /> DATE INSTALLED: Z�'�� �JI � OFF SUB TOTAL <br /> d b <br /> CUDC I L�BOp ANO EOUIPMENf RENTAL HOURS RATE <br /> � — Gp�,�Avra <br /> I � - <br /> --� I-- -- <br /> �.733�� � --- -- <br /> i - -- <br /> II ----- <br /> — TOTAL <br /> REMARKS: ___ __ _.__ — <br />