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, <br /> APPL� �V� �� � . SER\'ICE I <br /> No. 1 .� i:ITY ��F EVERETT ORDER NO. <br /> �-��� � AFFi.iCl1TION FOR IVATEn SEFVIC[ /7 <br /> � PIXEJ �,` DATE__�I�f1O _�8� <br /> �-7 U U ( <br /> j�OEPOSIT s C��' NnO.._ -_ _—_---_ <br /> �;;-��� i � —2�,-5 <br /> SERVICE (BYADDRce81_� `�� ��Q.L.+.yr�v�J1�=-BLK._--LOT___A�D.— <br /> OWNER���'C_�LL��Q-l�.L`]!-•�- CONTRACTOR. ---------- <br /> 3 '� F�r <br /> INSTAL� _ E'�RED SERVI�/_- _.-.—. --- ------- -- - <br /> I HEREBY APPLY FO�E--0E--WA7ER�iN ALCOPOANCE WITH THE �(��`� `, Jn_ �� <br /> ORDINANCES ANC POLIGES OF TME WATER DEPARTMENT NOW E%IS71NG eicHeo� C.4<«�_�LL�CL�"�?y1/_�---- <br /> OR AS SAME MAY BE HEREAFTER CHAN(iED. �= f^ _ <br /> MMERIALS � IN.� I��N. I 2 IN. I i 1 P91� AMOUNT _ <br /> PIPE �-i,: . ,- COPPER--GALV.•- STEEL ��� }I- I <br /> GORPORATION �-- _ ___ I —I -��--- _� _'_ _ <br /> CURB COCK 07 � __I__ _ <br /> SERVICE BOX PLASTIC - C I I �I _. <br /> METER VAWE _. -. __ ___� _____ I _ -'- -- <br /> - .. ._ . _ _ _ .. .__ _ ._. -_ -� _I <br /> METER NO. � � � TYPE: J�il:�[�_�n ,l `i i" __ _ __"- _ _— ___-_- <br /> ._- _ .-_�`_ _' _ __.. - - <br /> METER BO% ' CONCRETE � 5MA L'. LARGE I _ <br /> _— _ '_---i-.-=r'___-� —_ - .- __ - <br /> . I _�_I'._- - <br /> -- � i So� 3 — --- -I I _ <br /> _ _ - I —�-- -- — _ <br /> - - � ---- -- <br /> _ __ - --�I �—j=- -- — <br /> — ------ -— — I � � - <br /> � ON <br /> C�ATE INSTALLEO: � OFF SUB TOTAL <br /> CCIIE 'i LABOR AND EOUIPMENfRENiAL HOURS I RATE <br /> 1 <br /> ..�' f I I.L� . <br /> I _r ���� <br /> .--I _-_.._'._' -__ _ _.___'_'_ 1 C r-, __'i'-_ _ ____ _. <br /> - -I L/�� �d � ��- - - <br /> � /� µ�7�� ��� — <br /> — — - � <br /> — -- I — <br /> ,— -- - ---�--- — - <br /> TOTAL <br /> � REMARKS: ` ' <br /> �; L/ p P�$,....�,_ _kw.:,�.,_Z z���=�_-- --- -- ----- --- <br />