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'0'PPL• ' ./ � • � APrLICA�HON FOR SERVICE SERVICE ti� 3 3 3 <br /> No. oRor-.a <br /> I `� �� l (�. CITY OF EVERETT WATER DEPT. �� � o i� <br /> � FIXED DATE_ _19��_ <br /> / C <br /> � DEPOSIT y `QO �— W. O. <br /> _— �o..—_ <br /> SERVICE uar nooaessi_/�_� `' ' �7 � '�y ���pLK.—_LOL_/�ADU._ <br /> OWNER_U� N �/ 4 C K�`�N " r �_ _ _ _LONTRACTOF______ ! <br /> � - / <br /> iN5T.1L�Y_METERED SERVICE —_______ ____ _ <br /> I HEREBY APPLY FOR THE USE OF WATPR IN ACCOPDANCE 1ViTH TH4 � � <br /> OFDINANCES AND POLIQES OF THE WATER OEPARTMENT NOW EXISTIk. � /I n � /{S <br /> OR AS SAME MAY BE HEREAF7EP CHANGED. , sicNco: X��'xQXd _ i_�6<lLG�� _ <br /> .NAT[!I4L5 �� ��'� � �N_I � �N• I I FR�CF � AMOONT <br /> PIPE .,OPPER= GALV.•-STEEL _ � � ✓' I I� <br /> �_ L_^ • �2 �� <br /> CORPORATION __ __ I -- I� <br /> CURB COCK OT —� � <br /> SERVICE BOX PLASTIC •�C 1 _ I_ I — ��� � <br /> METER VALVE — I <br /> — � —_ 7 ��) <br /> METER No.��2�_3'�-.�.�/��' TYPE: ' CiLL�S� `i I— _. --i�.��-�_:. <br /> METER BOX (CONCRETE SMALC LARGE I _ _ _ _��I�j�' .._ <br /> � __ I / 'i <br /> — — -�.�°a- 'a�-1 �� � ---�—����-'- <br /> � — � <br /> i <br /> i � _ <br /> — —i� -- --J-—�— <br /> I � I � <br /> � �N <br /> DATE INSTALLH�: // � C � J �-�[OFF �� SUB TOTAL ,/ I'/� <br /> �`' . � .> <br /> COOE I LA�OR �NO EQUIPMEN�fRCNTAL � MOL'RS RATE � <br /> I�1.1�2 — _ I .� � ' � <br /> I __—__ _—' �� I� ` <br /> _�._'�.:�_ i_ •3_ -�r � I ;. \ <br /> ----- --- � !� i <br /> ' --- --- I I I <br /> -=i --- -- --- --- --- ------'i - -----','I----�- <br /> TOTAL j� ���� I��'') <br /> PEMARKS: <br /> — —_'_._ <br /> _r --_— - __-_—__' <br /> �R� _ �3� '2- _ <br /> -- _ � - . <br /> _ ' _. <br />