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APPL. ^ SP� � CITY OF EVERETT sERVICE ' C" '� n <br /> No. pC D ORDER NO. �t �� � ZY <br /> APPLICATION FOR WATER SERVICE �j,� p� <br /> � FIXED p DATE—.J� 19(L? <br /> � __ <br /> � � � DEPOSIT s d � W.O. <br /> SERVICE UrAOD11cu) . �• p ' D _ BLK.. LOTJ� ._ <br /> OWNEFL.�C� CONTRACTOR_ _ � <br /> 7/� <br /> INSTAL��TMETERED SERVICE_ <br /> I NERElY APPLY FOR THE USE OF WATER IN ACCORD�NCE WITH THE <br /> ORUINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING y/- - � ��L � <br /> nR AS SAME MAY BE HERE�FTER CHANGEU. eicr+co: X _�GF�«�L4' �1 �/'� <br /> "7 <br /> MAiER1AL6 �' IN. 11N. � 31N. I � PRICE AMOUNT <br /> PIrE COPPER•-GALV.--STEEL � _ I � <br /> CORPORATION <br /> i I <br /> CURB COCK OT � <br /> EERVICE BOX PLASTIC -- C I I I <br /> METER VALVE <br /> _ —. —�__--f— <br /> METER No. TYPE: � �S <br /> METER BO% CONCRETE SMALL LAAGE —� _I__ <br /> I � <br /> —I —�— _ <br /> I — —._ -- <br /> _ ——I _ _ <br /> I I� I <br /> DATE INSTALLED: �J���ip� I �pp SUB TOTAL <br /> / o <br /> COD[ I LABORANDEOUIPMENfNENTAL I HOUN3 p�TE <br /> � C�yr�� � <br /> I <br /> � I—— — <br /> - ���- -��- -- � - <br /> � � - - � <br /> i - -- �- <br /> TOTAL <br /> REMARKS: <br />