Laserfiche WebLink
vo. ,� ��/�'��� CITY OF EVEfiETT SERVICE I <br />APPLICATION FOR WATER SERVICE ORDER P�G. . � <br />7 FIXED DATE / <br />� 'Z� —18� <br />� DEPOSIT s � n C' W Q <br />No.__ <br />GERVICE tn UOREB61 A c• �/��< '.. / F 4� � <br />/%i �,� � •'i-� '__ �_E._�_'_BLK._.__LOT �_ q �- f+i <br />OWNEY��� ����� ��� 9 ��Y�_CONTRACTOR_ �� ��r � `� <br />INSTAL�_ METEGED SERVICE____. J.___ __. ___ ,_—� <br />I NEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EX:STING ,l /. �� �� <br />Oq AS SAME MAY BE NEREhFTER CHANGE0. „{ f1'�. / �" <br />eicHco: x. f c f/L C� / � <br />MATERiAtS � —�%— � �-��-- <br />��i �N. � 1 IN. I 2 IN. : �PpICE ' AMOUNT <br />_P�PE COPPER •- GALV. •- STE[L I I I I <br />CORPORATION _ --- �—I I �Ir— I�� <br />CURd COCK <br />SERVICE BOX <br />METER VALVE <br />METER No. _ <br />METER BOX <br />OT <br />PLASTIC •- C I <br />—_-'._ __.__'.--TYPE:__—_. ____� —_ <br />_.-_- ___. ._'_ __ _--. _ _- _ � " <br />CONCRETE SMALI LARGE <br />DATE INSTALLED: <br />CODE ! <br />REMARKS: <br />_-__-- -_ -__ _1-- <br />�' ON <br />- L� � �_�_ � OFF <br />IABOP ANO EOUIPMENfqENTAL <br />— - -- , � �,, <br />r <br />'� L <br />�� <br />SUB TOTAL <br />NOURS RATE <br />1,( <br />li -- <br />- I --I --- <br />TOTAL <br />� <br />