Laserfiche WebLink
NaPL' Z W W 3 � CITY OF EVERETT SERVICE o <br /> APPLICATION FOR WATER SERVICE ORDER N_ 5 4 0 5 <br /> DATE�/�A-��19�� <br /> � FIXED � <br /> � UEPO3IT s �� ryp�___ <br /> 1 n, r Fu1 fnn'3 L9nd,aY <br /> BERVICE c�v �oonceo>�-1� zZ�1-�� ✓Q S` � 7 eLK.__—LOT NDD._ <br /> OWNER— C ID(�J/}.JQS�YI/1 CONTRACTOR_—/_�-1`L,?�R-L/[w — <br /> 1� F�A-i' <br /> INSTAL�—EfAETERED ERVIGE—_ _. _ ___- / <br /> i :J��/ '� <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACGORDANCE WITH THE {�j</%�,i�;! //� �/ n <br /> ORUINANCES AND POLICIES OF THE WATER DEPAflTMENT NOW E%ISTING / /A/ //Y// <br /> OR AS S�ME MI1Y BE HEREAFTER CHANGED. elcNEo: % �. �=�!- - ✓�/��v- � <br /> MATERII.L6 �G IN. � IN. 2 IN. I PRICE A ❑NT , <br /> J� <br /> PIPE COPPER-- GALV.-STEEL I � <br /> -- ---- 1-- �- -!- - � I <br /> CORPORATION I I I <br /> CURB COCK OT I II <br /> SERVICE BOX PLASTIC •• C 1_ ___ _ I _ _I_ _ _. <br /> � <br /> METER VAWE __ __ __ ____ __. <br /> METER No. �O�_ 7YPE:PR�GU1.'1�_.I �"_ _ ____ __ _ _ -____ __— <br /> METER BOX CONCRETE SMALL LARGE _ <br /> ___. _ — ____-_I -- '_ - <br /> __--_'-___ --I — - <br /> -- '_I _ — <br /> _I <br /> —_____-- _ I �— _— I <br /> � <br /> ---- - � I_-I-i <br /> , I }a' ON <br /> UATE INSTALLEO: ���(�/y,D � OFF SUB TOTAL <br /> dQ <br /> CODE I LABOR ANDEOUIPMENTRENTAL HOUflS RATC <br /> i --- C��"ril� --I— - <br /> �—��,7��.�i -- --- I--- —— — <br /> � � — <br /> -- -- I -- <br /> — -------- —I— — -- <br /> i —. _ �— — <br /> TOTAL <br /> REMARKS: <br />