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ArPL. <br /> No. � � oj .��� CITY OF EVERETT e[nvicE No ]O O S <br /> APPLI;ATIOt. FOR WATER SERVICE oROER <br /> � FIXED Cn DATE��_�__�p gJ <br /> � �" � � DEPO8IT s �Q� � <br /> a��d NaO. <br /> BERVIGE ��r�oo�u�1- �3/S--� ,,(�.i,fG- BLK._ LOT.��qDD� <<w ./ <br /> '/ __�� JLJ. <br /> OWNE _�aL,l�'J^'!� ONTRACTOR <br /> r FLAT ���Q' <br /> INSTAL�_ �p gERVIC � D'� <br /> 1 HERE6Y APPLY FOR THE USE OF WATER IN ACCORDANCE WITM 7HE q <br /> ORDIN�NCES AND POLICIES OF iHE W�TER DEPARIMENT NOW F.%ISTING � /� ��/,/ JC <br /> OR AS S�ME MAY BE HEREAfTER CHANGEO. •ICHEo: X (X! G� 6 l.� ��� <br /> "`---- --- <br /> MAT[RI�Li yi IN. I IN. 1 IN. �� <br /> —_ — --- �� i� PpIC[ AMOUNT <br /> P�PE COPPER-•GALV.•-STEEL � <br /> CORPORA710N <br /> — _—._—�_.I—._ __ <br /> CURB COCK OT i I <br /> i <br /> SERVICE BOX PLASTIC •- C 1 I <br /> METER VALVE �I <br /> —_ _ — � <br /> METER No. _ . TVPE ___. .I-� — — _— .I .— __.__ _ __ <br /> METER BO% CONCRETE SMALL LARGE — <br /> —_ _ — __ __ —I —._I--_—. <br /> —I_—_ __ <br /> — I —�— <br /> —'__ I , — <br /> � _..__—__--_ I ��_ <br /> I I � I <br /> I �N � I <br /> DATEINSTALLED: OFF <br /> J/ SUB TOTAL <br /> CODF I L�BOR AND EOUIPMENf RENTAL <br /> .�L�I�G 7b/O Z MOUA9 R�TE <br /> I � _–'.___ _ �'_I <br /> I <br /> � �__ <br /> '____ — I <br /> I _- ___'___ I____ ____ <br /> �_ I '_� <br /> REMARKS: � �u�y� �1�•�� <br /> T07AL <br /> �c J <br /> n �va� � ac .- cecn ae5� mxvtt+ qe �o <br />