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�PL �-�G�'� 1 (c�.� 1��i'��1 �•5 `�/.�3ji} o <br /> CITY OF EVERETT I 6[RVICE N_ 6 9 3 5 <br /> APPLICATION FOR WATER SEflVICE ORDER <br /> � FIXED DATE—__( ,C�-.CJ �p/C�� <br /> � . � DEMfiT s � �. <br /> �{���'�c��Cl, No O. <br /> OWNE�sERVICE (�Y AODIIGq�}' ry�V D C� �BLK.. LOTJL/ADD. n <br /> � ��y/'��� -C��`k5�. ����K���� <br /> . CONTRACTOR <br /> INSTALL�"L LAT <br /> METERED gERVICE__�L � � <br /> I NEREBY APPLY FOR THE USE OF WATER IN ACCONDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE W�TER DEPARTMENT NOW EXISTING <br /> OR AS SAME MAY BE HEREAFTEH CHANGED. <br /> •IGNEO: X <br /> MATERI�L6 Y� IN. 1 IN. 3 IN. � �- -----_-� <br /> � I 1 RICE <br /> ' ��rE COPPER- GALV.••STEEL � _ <br /> CORPORATION <br /> CURB COCK OT I I <br /> SERVICE BO7( PLASTIC - C I I - - <br /> METER VALVE — - <br /> METER NO. --�-'- _ TVPE: _-'�� I .S -"— -- <br /> METER BOX CONCRETE SMALL LARGE <br /> - — i_.__I_ _ _ <br /> _—I �—I— <br /> _ � <br /> I I� I <br /> DATE INSTALLED: <br /> s i s� I oN � <br /> � OFF SUB TOTAL <br /> CO�E I LA80p ANO EOUIPMENf RENTAL <br /> , I � HOUR9 NATE <br /> �� L - �__ __I — <br /> I � - <br /> - — — � - <br /> � ----- - i-- _ <br /> _ � �— <br /> REMARKS: TOTAL <br /> c������2�_,;�'S'�' <br />