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. <br />APPL�.� C 4/� / I <br />No. � CITY OF EVERETT - <br />SERVICE <br />APPLICATION FOR WATER SERVICE ORDER NO. <br />� FIXED �y�71L {�/J �J �JQ'/ <br />n OEPO5IT S �Z� �'_ DATJj'_-"-1-�( �-18/�l�. <br />W.b j <br />,/ No._,(�__/'— <br />SERVICE (OY/A�ODRE881� / L_� � � ���(,y �%////� /� 7� S"���/.('tl �} �[ <br />/ / � -'f �'-i--LCQ-�BLK.j- LOT q[bs�,C/2Y_7 <br />OWNER__,QL�GfitiC�T ._,,� r <br />/ �� — �--CONTRACTOR__ <br />INSTAL h1ETERED SERVI <br />I HERE9Y APPLY FOR THE USE OF WATER IN ACfORDANCE WITH THE /� --- <br />ORDINANCES AND POLICIES OF THE WATER OEPARTMENi NOW E%ISTING w/�� <br />OP. AS SAME MAY BE HEREAFTER CHANGE�. <br />BIGN[O: % . L�� ��.`� <br />1 . -_-______.___ <br />MMERIAId ii IN. 1 IN. � 2 IN. � � �- <br />P�PE ,.��i I PHICE ' AMOONT <br />�_-- .... I <br />COPPER -- GF LV. -• STEEL �' � �� <br />_CORPORATION �-'-��-_ -..--Y i I-'-- <br />-_-. ' � I— �J <br />CURB COCK OT I I <br />SERVICE BOX _ pLASTIC -_ C � I <br />ME7ER VqLVE � � � � ��— � <br />METER No. ' -- -',_ . �' . TYPE:_._ -.. __ . _I --_-'-_ ___ _- <br />.� <br />METER BOX CONCRETE . � �SMALL LARGE � � <br />- - ,--- -- -- - ,-� -��_ - -- <br />� _ � _ �--I -_ -- - <br />- __i _i_ ---_ - <br />DATEINSTALLED: I �� �N <br />� OFF SUB TOTAL <br />COOE <br />IADOP ANO EOUIPMENlpENTIL <br />I� I MOUqS R�TE <br />I —_ —_____ . . , . <br />._.__.- _.._—. -_—__ _.__ <br />l.�_- _ _.____ <br />— -f.� -. ___ . ;. . -_ . _ _— _ _ <br />/� �q/� i � ✓' l� I <br />__ ��'/�V..�_-. t�. _. '�ti) "r-- I <br />I � __.'-_ - ___ <br />--I -_ _'__ . .__' _-__-- -I_- _ __ - _ <br />I_—.-_.. __-- --'-'-__-._--_ I'-_ -- - - <br />I <br />� REMqpKS: TOTAL <br />