Laserfiche WebLink
I <br /> r:oPL �^ �3�JY / CI1'Y OF EVERETT SERVICE � ��., n `,_ <br /> ORDER NO. � - <br /> APPLICATION FOR WATER SERVICE o �jC� � � p' <br /> � FIXED �� C�tT� �-19a2 <br /> � DEPO5IT S �7O � W��. <br /> - No.__ <br /> /� .�l'--/���- � ��-/4�y� � ,-s� � <br /> SERVICE <BVADJReg � {�� B�_K.__..LO �_�� <br /> OWNE��'✓� ��// //'��.� "' ""-- " CONTRACTOR_ ��t�-- <br /> 3 ii �� ---- --- - - <br /> INSTALL�_-METERED SERVICE_- .______ _ ___ ___ <br /> I HEHEBY APPLY FOR THE USE OF WATER IN ACCOPDAHCE WITH THE - / -- <br /> ORDINANCES AH[I POLIQES OF TH[ WATER DEPARTMENT NOW E%ISTING �� /� <br /> OR AS SAME MAY BE HEflEAF7ER CHANGED. eIc � % . �,J`_ <br /> MATERIAL9 yi IN.� 1 IN. I IN. I � PpICE � AMOUNT <br /> PIPE COPPER-� GALV.-• STEEL __ __ � <br /> CpRPORATiON-- i� - <br /> CURB COCK OT I� <br /> SERVICE BOX PLASTIC •• C 1 I ��I— -- — <br /> METER \'ALVE <br /> METER No.___"-.-�_- TYPE: _--'_-I `S —�_'—__ �_ __� ._ — <br /> METER 60X CONCRETE SMALL_ LARGE � � <br /> ___'.l'_ i _ _ <br /> _ � � �_-- _ <br /> _ _ I __ <br /> '_I ___ _ _ <br /> —__ __"_ _ _ _ I <br /> - _- -_ _-'_ I -__ -- . ��... <br /> - I __I_ <br /> ON <br /> DAl'E INSTALLED: � _']�O _ � 3 � �FF SUB TOTAL <br /> COOE � LABOR AND EOUIPMENT NENTAL NOUR: pATE <br /> � S -T�( 11_ NR <br /> _ ! Z,-C�� �� „ _ _ <br /> i �z/// _I / -" --- <br /> . _ -���z��t------ -- �-- <br /> � , <br /> -; - - <br /> _ _ , --�-- -- -- <br /> TOTAL <br /> REMARKS: <br /> � <br />