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p�pp� , � � � � APPI_ICA?'ION FOR SERVGCE SERVICE� Z G 2 <br /> No. ORDER <br /> -��f�� j �ITY OI' EVl:RETT WATER DEPT. oA.�_ _� /� _ ��J <br /> ��Fixe w. o. <br /> � DEPOSITE1CD,�O No. --- -- <br /> � - .3'�=� �� <br /> SERVICE (e/Y 1AooPqssel--� BLK. LOT �D'�,— —._ <br /> �__- -- <br /> OWNER " � " • '�2� ���������-'- -CONTRACTOR - --� <br /> /� �� FLAT � L ' J � <br /> I NSTALLLL--��SE RV i C E--C=1G_�_-�L��L�, --'- <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE � <br /> ORDINANCES AND POLIGES OF THE WATER DFPARTMENT NOW EXISTING slGr+co: X_- ---�------ - <br /> OR AS S�ME MAY UE NEREAFTER CHAN6ED. <br /> �� IN. 1 IN. 2 IN. I PRICE � AMOUNT <br /> NATER14L5 I I I L ,� ) <br /> PIPE C COPPER,-GALV.--STEEL ___ ' J�'�I J I'���) <br /> ^ � --- �—— I� � �, <br /> RPORATIOI� <br /> CURB COCK; OT� � � �� � � <br /> _ _- I c7 <br /> SERVICE BO% PI_ASTIC --� � _ �-- <br /> METER VALVE __— — —-— — <br /> METER No �—'�-- TYPE: _ I •.'. _ — �-'_- <br /> METER BOX � CONCRETE SMALL LARGE __ _ _ ��--� I — <br /> -. _'_ � � / —I �I n1 I!� <br /> _-CO_4���L"__ <br /> � -�---� - �U� <br /> �--y�r� � � _. <br /> -� _ _ �--f-- <br /> �-i � I I <br /> I � ON ^� C � <br /> � SUB TOTAL �j " <br /> OATE INSTALIED: OFF � <br /> - /n ��- � I ❑ -,.. <br /> MOURS RATE � <br /> COOE I LPBOR ANO EOIJiPMENT Rf_NTAL I _ <br /> I�/ — —_ —_—_" — 1� _ 1 ��� �r ': ''-. '� j— <br /> �� f� 7 I �I I • .. <br /> I -- ( I <br /> _ __. `S�� / � .. ' I II ' I ,�. <br /> IV �� i _ _ .a._ <br /> — � �� I' <br /> --�-� � z '� , r '--?'�=�'----��- --J,'i_�- <br /> � -- -- -- <br /> -��I—._-__._--_-___ .__-- ____-.__. I TOTAL I�I V,I..iC <br /> �r w �� '7 � <br /> REMARKS' I C C�� C o--�_Y v2_L;�-:�(1.2.Vf����--L1�_G. L��.__!._t /�'LG.L�-- s�/ ��.:- <br /> / � J � <br /> �O. C�Pc!LO.. .__ _ . _-- . _—_ —_—_' <br />