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1 <br /> APP��`��� CITY OF EVERETT SERVICE . . � . , I <br /> No. ORDER NO. .. � � <br /> APPLICATION FOR WATER SERVICE <br /> � FIXED DATf2Lf_iir'-�1$� <br /> � DEPOSIT . Q/J�� N'd_ ______ <br /> �/'� /� <br /> �-��� � � <br /> SERVICE ter �oonces�JL��� —(fCL`���`� BLK._—_LOT_ <br /> OWNER __ _CONTRACTOR __ <br /> INSTALL_r'�_—E'fAETEREDAT SERVI�E��— ___- - _-------- <br /> I HEREBY �PPLY FOR THE USE OF WATER IN ACCORORNCE WITH THE � <br /> ORUINANCES AHD POLICIES OF 1HE WATEN OEPARTMENT NOW E%ISTING V (�✓� <br /> OR AS SAME MAY BE HEFEAFTER CHANGED. sicpco: 7(���_---__._ <br /> � MATEPIALS w IN. � IH. 'i 21N. � I �RiCE I AMOUNT <br /> PIPE�� � f� �t� COPPER-- GALV.-STEEL �_� � <br /> .� 1.�0�F__- __-- — i <br /> CO�tP6RATION I � <br /> CURB COCK OT � I <br /> SERVICE BOX PLAS7IC`�C�1 I I _ _ <br /> METER VALVE __ _ � V" � __ I ___I __ _ ___ <br /> _ . _ r.__ _ ^.� <br /> METER No�. \ . �� �TYPE: . '� .. f _ L_ __I ..__ _'___ .. <br /> i:Yr � .__V.- . . 1__L] i �. <br /> METER BOX ( CONCRETE - SMALL LAFGE� I <br /> ��--- ��� . _---n_ �� ' _'�_ _ _ � ���—_ <br /> A __ __ _�_''�_._ �d_. <br /> J, n .� ' i �_'__ _ <br /> _ �� `� - ' ,�. ��' --II ,�- � I— — <br /> - ,.. _ ' . . - -- — � II— <br /> � ',=�'--- - - -- ,�.. i <br /> _�, �' I <br /> --- -- I II I--- <br /> � Q ON <br /> i._ - <br /> OATE WSTALLED: , ' � � . /� ��/ � � pFF SUB TOTAL <br /> / ! <br /> COOE I � LAAOR AND Eqi11PMENfRENTAI I HOURS RATE <br /> -_-._- ._. - _ .-____ - . _ -.-- - _ _ . _�_(_-_-II� . _-_ <br /> J l <br /> =-�------ - - ---- <br /> -- -��/^- -� '� � � , dD � '� - - — <br /> - - ---- ��--. � L2�� _ <br /> _ ------ -------' �I s a�3 ��— — <br /> - ---- _— --- - -- <br /> TOTAL <br /> tEMARKS: <br />