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APPL. � / � ^� <br />No. UJ d <br />� FIXED <br />0� <br />CITY OF E�'ERETT <br />APPLICATION FUR NATER SERVICE <br />ORDEIR E NO. � U J O <br />DATE_.LL�_ � � <br />/ " <br />Id DEP061T s IQIJ W. O. <br />y+l <br />No. <br />9ERVICE�er�oc�cssl �I/l)J��_77� �%p � 7, �P��'/t���✓� <br />BLK..__LOT�S]�ADD. <br />OWNER G�,Ir�p� n/�i.i J�(%Jr CONTRACTOR SQ.�L{% <br />INST.�LI_� �( METERED SERVICE <br />I HEREBY �PPLY FOR THE USE OF WATEH IN ACCORDANCE WITH THE Q�� O /� <br />OHDINANCES AND POLICIES OF THE WATER DEPARTMENi N:d E%ISTING ,-//. , \��\�_ /r_ — <br />OR AS SAME MAY BE HEREAF7ER CHANGED. slcHEo: X. {.iC.•C.` �f%`-C-.�� <br />MATiR1ALe 14 IN. 1 IN. � 1 IN. I � -PRICE y( AMOUNT <br />P�PE COPPER - GALV. - STEEL I�I I I I� <br />CORPORATION <br />CURB COCK <br />SERVICE BOX <br />METER VALVE <br />METER No. <br />METER BOX <br />OT <br />PLASTIC -- C I <br />CONCRETE <br />DATE INSTALLED: <br />COOE <br />REMARKS: <br />TYPE: � !6 <br />SMALL LARGE <br />I I I I <br />ON <br />�,l � OFF <br />LABOH AND EOUIPMENfRENTAL <br />L_u6�f.�'rtLTu' <br />SUB TOTAL <br />HOURS � RATE <br />