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APPL. il/L]�/� CITY OF EVERETT SERVICE <br /> No. OCIU �•�( ORDER I� <br /> APPLICATION FOR WATER SERVICE �� ��7 �� <br /> �FIXED DATE__ a. 19 <br /> � DEPOSIT � W'�' <br /> t No.—'—____-___ <br /> SERVICE ler AooREiel-����—L./-11A��SCfL.-t �' —BIK.___LOT/V ADD.J�I�"��'•✓V=� <br /> OWNE � � CONTRAGTOR_���C�_ <br /> L I �l LAT <br /> INSYAL � t" HtD SERVICE——- - - <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE W1TH THE �j � � /� <br /> ONDINANCES AND POLIQES OF THE WATER PEPANTMENT NOW E%ISTING � _� /'�� ���(�.tC� �_ <br /> OR AS SAME MAY BE HEREAFTEfi CHANGED. 81cHEo: X . --_-. r --- <br /> MATERIALS w IN. 1 IN. � 2 IN. I I PHICE AMOUNT <br /> PIPE COPPER•- GALV.•-STEEL __�_� � <br /> CORP04ATION <br /> CURB COC.0 OT _I I I <br /> SERVICE BOX PLASTIC •• C I <br /> I _� I <br /> METER VALVE _ _ _ __ _ __ __ ___ <br /> METER No. __—_..-- TYPE__--_ .I .�''-- _— _—__ - _ <br /> METER BOX CONCRETE SMALL LARGE _ _ _ <br /> '__ __--- —_I _�-_ - <br /> —_-_ _ —i— ��_ — _ <br /> _I <br /> — I __ ___- <br /> ___._- ' - _-_ _i __ _- _ <br /> . � . . . -..� I N <br /> DATEINSTALLED: ' � ' OFF SU6 TOTAL <br /> COO/E'� � � LAUOR ANDEOUIPMENfRENTAL MOUPS RAT6 <br /> H I / /�l / � � L (?_r1�1�)�l"�/�____-__ -- <br /> J ' _GC�LL <br /> I � <br /> I _ - _" <br /> - - - I - -__- <br /> - - _- I <br /> I _ ____ _--_ __"" __.__�y._ _ _ <br /> I I <br /> TOTAL <br /> REMARKS: <br />