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Tn I��STING__�_�_s�{.--- <br /> APPL. /��j� �J� CITV OF EVERETT StNVICENo <br /> N� / 7 APPLICATION FOR WATER SER"V�ICE oftoER B 0 4 9 <br /> �XED �I�O � -f"/�ZID DATE� J /�J�IY_ . <br /> � DErOa1T e -ff�l _ W.oO. <br /> '� f� I /� _ <br /> eERVICE t�r�oo�u�)1�/Y ��L.' JL/� �SC / BLK.._ . _LOTJ-�AOD. <br /> r ' <br /> OWN�R � � � � CONTRACTOR <br /> 1 F <br /> INSTAL�� TER RVIGE — __ . <br /> I NERElt A�PL� FOR TXE USE OF WATER IN ACCORD�NCE WITN TNE <br /> ORDINANCES AND ►OLICIES OF TME WATER DEPARTMENT NOW E1(ISTING <br /> OR AS S�ME MI1Y BE XEREAFTER CHANGED. ncraED: % __________ <br /> MA1ER111L/ R IN. 1 IN. '� 3 IN. � PpICE � AMOONT <br /> PIPE COPPER-• GALV.•-STEEL I <br /> CORPORATION _� �� � <br /> _— — I I J — <br /> CURB COCK OT j <br /> SERVIGE !OX PLASTIC -- C I I I <br /> . . .—.---_-- --+I-- � . <br /> METER VAWE ' <br /> —____--- . _ . -I _— —_ _ d __ . _- . .- ._-_— __.._ __.__ <br /> '� METER No. ����U__ __ TVPE: qE'L�/S_!-O!�/ _.�� __.I_/1�—_.,__I _ ._ _ __ ' <br /> METER !OX CONCRETE _ _ SMALL LARGE 1 I I . _ <br /> I � I <br /> — -._- . __I_�_J_— <br /> I i I <br /> � � ___- _'__ '__'_"_.--- �I---I-I__ _-_-_ - <br /> J i- ___ <br /> � I , I <br /> ON <br /> ' � DATE INSTALLED: / ��� - �./ I � OFF SUB TOTAL <br /> �� 7 <br /> CODE � LAlOR AHDCOUIPMENfRENTAL I MOUq9 qATE <br /> i�� -- ---- - � <br /> � -� <br /> --- i - <br /> __-----[yA-ACt10N I — --_ <br /> —� — — w.lq�fakensn service � -- - — <br /> � p�P�ca!ions without a —I - -- <br /> � Backilow Preven—�ion Cori�aitatto�— — — — <br /> TOTAL <br /> REMARKS: �/�i��/,S• ��� ��/ __ <br /> /lada!vy.—q <br />