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--, . <br /> � -� <br /> r <br /> � <br /> �' 1 <br /> APPL.�'/� f(`Q� CITY OF EVERETT SERVICE ' 1 : : ��� <br /> No. fa y�y oaoeR NO. � <br /> APPLICdTION FOR �VATcFi SERVICE �y,/' <br /> � DAT _- �_-1B✓'. <br /> J FIXED �.i� <br /> � OEPO5IT /� _ W��' —- <br />� <br /> s b L' No._-___ -__ ._ <br /> // �j �/ 7 �� �^ <br /> SERVICE {eYAo ' 'sl_7//____✓-___ - -.---�Lr[��ZC._BLK.--_LO1V��� <br /> i� a , - <br /> OWNER�i�<L�f/J�i���/�-�x�-- _�-GONTRACTOR' _ _ __. _ _ —'_.___ - -_---_' <br /> /� f <br /> INSTALL��J/ METERED SERVIGE_-- -___ -- . .- - - - . - - — - ------ ------- <br /> I HEPEBY APPCY FOH THE USE OF WATER �N ACCORDANCE WITN THE <br /> OflDIN�NCES AND POLICIES OF il1E WATER OEPARiMENT NOW E%ISTING �� �C�-- <br /> OII AS SANE MAY BE MEPE�F7ER CMANGED. slGu - -- . . --_ _.--. --.-- - <br /> MATEPIALS I W IN.I � IN. i N. �� � PHICE � AMOUNT <br /> PIPE COPPER•-GAW.--STEEL �� _ � I _ _ I _ <br /> '_'___ _—_ __"_ —___ ._I_ "'I_ <br /> GORPORATION I I� _I__�__ _� . _ <br /> GURB COGK OT � I I__ _ I —_ <br /> SERVICE BOX ___ PlASTIC _ C 1 _ ___ I �I _. <br /> METER VAIVE _ __ _ _ _ ___— —— <br /> METER No.___—._ __ �_ . . TYPE: _ .—_ I ��— _.�--�I _ _ _ —__ _ <br /> METER BO% C9NCRETE SMALL LARGE <br /> ____.____.__. _— " " _,--I � _ ___ __ — <br /> _ —__ '_ —_ _ "__"_'_ ' _— <br /> I <br /> —. — _— -- _—I _' _ __ —_ _ — <br /> _-- _�—i �. _ _"_". — <br /> —' _—_— -- —�I_-- I .. —_ _ — ' <br /> I/ �['�-ON <br /> OATE INSTALLE�: �/ .��7/Y; �� I � pFF SUB TOTAL <br /> �� <br /> CODE I � LApOP AND iOl11PMENt PEHTAL NOOfiS P,�TE <br /> �� - � r . <br /> I . ._ . _ . � ....=^ ' �t- <br /> ________ __. __ . _. _ . —� j �._ . . <br /> —I� -----_S�Ja ��� �--—��11"'1sC"� i---7' - --- - — <br /> �� --- - --- <br /> ----- <br /> — --- _ ,- <br /> � - -- ' - — - <br /> ; -- - - --- � -- --- <br /> — -- � <br /> TOTAL <br /> REMARKS: <br /> � - - J <br /> L "� <br /> � <br /> \� <br />