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t <br /> ��PPL' �3���J CITY OF EVERETT se4vice �� � , <br /> No. ORDER NO. <br /> ���� APPLICATION FOR IVATER SERVICE 'J�� � /,�� 19� <br /> DATE�{' <br /> � FIXE /�� <br /> � DEPOSIT s �j C� W � <br /> '___ n /J {' <br /> No.-_.---_______- <br /> SERVICE �er �oog.� �-�OI �?�-'��tJ--/)---� uv _ -r��BLK..-__-LOT(�j-0 -K�-�/- ,4�*�' <br /> // ' �% <br /> OWNE:t�``/k� 1{E4___._X-YLCi._ -CONTRACTOR_.-._.-. ._-.- _-_- _--'.____ <br /> INSTALt�/� * MET�VICE_"-- '- - -' --- -- -----'--- "' - <br /> / <br /> I HEREBY APPLY FOR TNE USE OF WFTEF IN ACCORDANCE WITH THE <br /> OflDINANCES AND POLIGES OF THE 'NATER UEPARTYENT NOW E%ISTING 91GNE . 1 - �----'-.__ <br /> OR AS SAME MAY BE HEREAFTER CNANGED. - " - <br /> MNTERIALS I � ��' � ��' I �N• ' I PHICE AMO�INT <br /> PIPE COPPER--GALV._- STEEL _ �_ __ _I_____ __ <br /> � i <br /> CORPORATION _'___'___________ _ �— --- — -' -" <br /> GURB COCI: OT � I � ^ <br /> SERVICE BOX PLASTIC_- C I ______ I ,, ... -- — - - <br /> METER VALVE _ _ � � - ' -- �-�- <br /> _ __. . _ . . - - _ i <br /> — __-- <br /> METER No. TVPE: : __ _ _- . - - — --- � <br /> METER BOX CONCRETE SMALL IARGE ` I _ � __ _ . _ .__. . _ - <br /> _-- _' .-_'____. _ _-._ I_-_—I__L�-I - _ ---_ _-. .. <br /> — —_-._'_ . _ I -_. -_ <br /> __- ___ __ - <br /> � —'...__._ _ . __- -_-_ <br /> _' --I_ _I_ _. _. _ _ _ -_ _____. <br /> . I -'_ ' -_ -- <br /> - _-- -____ .__-"_'_ - ..__ __',I_ -I I I I I _ '_ _- <br /> I N/ ON <br /> V} SUU TOTAL <br /> OATE INSI'ALLE�: Q � // � �� rl OFF <br /> (J � <br /> LABOR ANO [OUIPM[NfPENTAI HOU95I RAiC <br /> ODE ; � <br /> i _ 5. SC)C _I I_I-I-� --- -- <br /> __-- ---- . <br /> ------ - - , �r_ __ „ <br /> i 6 le h '-L -- --- — — <br /> — -- -- <br /> --- � � 2�r � "- - -- - <br /> _ _ __ _ -- ---- <br /> ���p d� -- _ - <br /> i -- — -- <br /> - -- -- - -- <br /> -_ --- -- <br /> I _— _ - -_------------�-- -- ---- <br /> I - TOTAL <br /> REMARKS: ---------' - -' <br />