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i <br /> `'PP�• CITY OF EVERETT ORDERE NO. ):� J <br /> N�. "�� 3 3�,- . <br /> (i l�PPLICATION FUR WATER SERVICE <br /> DATE '� �' —1�Q. <br /> �/FIXED �� <br /> TCJ DEPOSIT ���j' � �.Wj'O. <br /> %4 !� ' J � �/�) t� <br /> SERVICE (BY AODRE681 � �S' �/ELV� �jO <br /> BLK._ LOT__LLADD.L1_—�_`�`� <br /> OWNE �A���=� `S'�" " CONTRACTOR <br /> FLA7 <br /> INSTAL ,•��ERVICE <br /> i HEREBY APPLY fOR THE USE OF WATER IN ACCOROANCE WITIi THE <br /> ORDINANCES AN� POLICIES OF TNE WATER DEPARTMENT NOW C%ISTING <br /> OR AS SAMC MAY BE HEREAFTER CHANGEO. etcrvco: X _— <br /> M/.TERIALS �i IN. 1 R6 � 2 IN. i I PPICE AMOUNT <br /> � <br /> PIPE ��___ E � <br /> CORPORATION <br /> CURB COCK OT I I� <br /> SeRVICE BOX _ PLASTIC •- C �_ _ I I _ <br /> METER VALVE <br /> _METER No. _ ._.. —�TYPE _ __ __I __�A (_ __ _ _ ___ _ <br /> METER BOX CONCRETE SMALL L�iRGE <br /> _—. _ — i_�I�— <br /> � _— —. .. —. - —I— — <br /> _��a0�•-�3 � - �—J i <br /> — w�3���-�--� �-- -- — <br /> --- --i—� �- � �— <br /> , <br /> �� � <br /> \ DATE INSTALLEII: /� '��a� I n OFF � Sl1B TOTAL <br /> CODE � LADOR �NO EOUTAMENfRENtAL MOUHS R�TE <br /> �� ---I_� . <br /> II -� -- I-�- --- <br /> -_ _�� -�-,`C�K� - -- <br /> -_'Q��- ----- -- i� - <br /> _I -_------ -- - -�_ <br /> TOTAL <br /> REMAROKS: �����y /�_�_����._.��J_K�� <br /> 16�;-4 <br /> if-g ,�• �� � <br />