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/ c�JCS�i2S CD ib <br /> AppL. 28'�,�� CITY OF EVERETT / /4� ORDERE N� 7 0 3 6 <br /> N°• APPLICATION FOR WATER SERVICE <br /> DATE���'---�O� <br /> � FIXED G'� � W,O. <br /> •.r, <br /> � � DErOS1T s �� � No. <br /> ���j�-�9 �,vn L"P SE BLK.. LOT�ADD.R/DSE��_- <br /> SERVICE (�Y AOOPnaI�'��•-�---- <br /> � F�SL�Y n���� GONTRACTOR <br /> O�NNEA�— <br /> 3/ �� ��,,.,.G � 7��_ ^ �-7 <br /> INSTAL�./ ^�'z"��' "— � <br /> ORDIHAHCES AND POLICES OFETME WATER DEP�NTMENT NOWWE%6TING �— __ <br /> •IGNED: % �-- -- <br /> ON AS SAME M�Y BE HERE�FTER CNANGED. w�H. t �H. � 2iN. I I Pp��E � �MOUNT <br /> M�TERI�lB <br /> P�PE COPPER-- GALV.--STEEL _ _I� _ <br /> CORPORATION _ — ,I <br /> CURB �COCK �T —�I <br /> SERVICE BOX PUSTIC •_C 1 — — -- <br /> METER VALVE -_ - __--- . --..�--' — — --- <br /> —_ TYPE: �� <br /> METER No. �. _._ - -- -- '"— <br /> "��-----� SMALL LARGE --- - <br /> METER BO% CONCRETE _. —I -- <br /> ��--�'—_ <br /> - __ �_�-1- - - <br /> -� � <br /> - -� �- <br /> --i �_�- -- <br /> _-- - i <br /> -- - � <br /> N <br /> SUB TOTAL <br /> DATEINSTALLED: �G�� IQI � OFF <br /> AMENfPENTAI I HOtIRS RATE <br /> L� I <br /> C0=_E � I <br /> �/ _�o/ --- — � _ <br /> I � — <br /> —_ — — -- i-- — <br /> I - -- I <br /> ---�I -- � — <br /> I TOTAL <br /> REMARKS: < Ei'l,v - � �C� � ` -" <br /> nr_ zr. .... mr.nar- O �^ TJ � � ms7: i.! <br />