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� � <br /> , <br /> , <br /> NOPL ��lD.7CI CITY Of- EVFRETT ORDERE �1 o <br /> APPLICAT�OM FOR WATER SERVICE IV_ �/54Ory7 <br /> � FIXED DATE_1�(,�. � 7-19s7.� <br /> � 4_- <br /> � <br /> � DEPO5IT �O W.O. <br /> No._ <br /> � /'� /'� �� /�.�7 �{�/y� Fulldn:5 ��wl�nc� <br /> SERVICE IeY ADDREetI—��J�-�l / '��/11L�.��iL_/ BLK.. LOT- DD.- <br /> OWNER—l_..(_Q.Lll-ILV���I� -GONTRACTOR��L�+JL�CIJJ�-� <br /> � '� �'� <br /> INSTAL� METEeED ERVICE_ -y --- <br /> I NEREBY APPLY FON THE USE OF WATER IN ACCONDANCE WITH THE <br /> ORDINANCES AND POIICIES OF Tl1E WATEF bEPANTMENi NOW EXISTIHG , ] <br /> OR AS SAME MAY OE HEflEFFTEN CHANGEU. elGnso: % . . - ,__,�� . _��1/ - --- -� <br /> M�TERI�L6 4i IN. 1 IN. � 2 IN. I PPICE AMOUNT <br /> PIPE COPPER•-GAW.--STEEL _ i_ _ _i_ i_ _ _ <br /> COftPORATION � _ __�___ <br /> CURB COCK OT I I � <br /> SERV...E BOA PLASTIC - G I I _ _. <br /> METER VALVE <br /> --_-_-..__ __ __ _-- . _ - -- ' __ -'_ '__- _- <br /> METER No. l7 TYPE: GISIJ.Y •f �---- '� __ <br /> ���_-___. �.�_-_- I __ __ - ' _-__ -._ <br /> METER BOX CONCRETE SMALL LARGE � <br /> _ _I__' _'.___ __ "_' <br /> - ._- _'_'-_ —I _- __ - <br /> I _l�._- -- <br /> _I I_ -_ — <br /> I �_�_ — <br /> _"_-"- __I__- I -_ <br /> II �J"__'_ - <br /> ___— �__ I — I— I--- <br /> ON <br /> DATE INSTALLE:1: (1 �1 n� j7 � OFF <br /> SUB TOTAL <br /> s- � �< <i <br /> COOE I LABOR ANO EOUIPMENf RENTAL I HOURS flATE <br /> � _ �'�.t��'1�_�--__�I——. <br /> I <br /> �-1?�2.7-8' ?z-- ----- �--- ---- - <br /> � � -- -- <br /> i � - -- - <br /> � ----- - -- � -- <br /> TOTAL <br /> REMARKS: <br />