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� Colo 3 <br /> wPP�. , CITY OF EVERETT SERVICE <br /> No. APPLICATION FOR WATER SERVICE ORDER �p �40� <br /> � FIXEU � DATE_.�/.(y_ IB <br /> y- - <br /> � DEPOSIT s �o� _ ��-- <br /> /'� ? /^J #3 FtiNrn;s �anol�l� <br /> SERVICE �ev�oo�[ep_�Q������z� lL- yj��/1��-�_BLK._ LOT ADD._ <br /> OWNER C �a�dLLyl'S ) P/✓l CONTRACTOR_�-Ci�.-sL�JJ�T__- <br /> n FLA7� <br /> INSTALL�—�.IETERED�RVICF-.--. � <br /> I HEREBY APPLY FOR THE USE OF WATER IH ACCONDANCE WITM 1HE <br /> ORUINANCES AND POLICIES OF THE WATER OEPARTMCNT NOW E%ISTING ��� <br /> OR AS SAME M�Y BE HENEAF7EN CN�NGE�. e�cr+eo: X ' - --. ..__�Z __. - <br /> MATERI�LS 1 �iIN. � IN. � 21N. � � PRICE AMOUNT <br /> PIPE COPPER•- GALV.--STEEL I 'I __J <br /> I <br /> CORPORATION � _I � _I_ I _J _ <br /> CURB COCK OT I I I <br /> SERVICE BOX PLASTIC •- C I I � __ . <br /> METER VAIVE _. _ . _ _ _ '__ -'_.'_ __" -' _"_- _-'- <br /> METER No. �O�__ __-_TYPE:PRI%GISWfi_I _��'-- —_ _-_'i __. ' _-_ ' <br /> METER BOX CONCRETE SMALL LARGE � . __ <br /> ___'I -I-�_ - ' — — <br /> — �� ����� _ _ _ <br /> _'___— _ I'_ <br /> I I�— — - - <br /> I I � <br /> � ON <br /> DATE INSTALLED: 2��(�i9J� I � OFF SUB TOTAL _ <br /> ✓✓ <br /> CODE I LA�Op AND EOUIPMENf RENTAL � HOl1P5 RA1E <br /> � ---- ----- ���---�—� - <br /> I -- <br /> —� o zz�a _a3--- -- �-- -- — <br /> � �-- <br /> -- -- -- � -- - - <br /> --- -- - - - <br /> — �-- - -- <br /> - ---- - <br /> i ------- - i <br /> 70TAL <br /> '�EMARKS: <br />