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2a7-�s <br /> l.spPL. �J O7�/ APPLICATION FOR SERVICE SERVICE y° 'I G S L <br /> No. �" �T� ORDER <br /> CITY OF EVEkETT WA"'ER DEPT. <br /> �FIXF_D � '�3 �--� DATE�—Z3 __iB!_L <br /> W.O. <br /> �CP�Slr S___— No.___ <br /> ��^�.r�iC /� J/J . <br /> SERVICE (Br eDoac351_i�ld±--!!uK'���� C�`e- � __BLK.�__..OT,�ADD.�•"'�� � �� ��. <br /> �J ,�}, 'i7' <br /> OWNER�Qd�V(.2CkLL� . CONTRACTOR�li�_Ll�:�'��<'1 <br /> INSTALL�L�� �������L-n-V'�� P <br /> �'4�I.: '-�--__ <br /> I NEHEBY APPLY FOR THE USE OF WATER IN ACCOfiDA�CE \41TH THE ��_' .� .�-1 ,' <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING . ' <br /> OA AS SAME MAY BE HEREAFTER CIIANC�:7. sicnm: X�. ,_.(, L-i. � � �•� - - - <br /> MATENIALq '�/� IN.I 1 �N. I L �H. -� PRICE � AMOUNT <br /> PIPE COPf-y'H-- GALV.••STEEI . � <br /> �— _ I�V,` I �� <br /> CORPORATION _ _� I �_ - � � II—Cj I � I <br /> CURB GOCK OT I I II I <br /> SERVICE BOX PLASTiC -- C I I I�,I <br /> -I_ -'—�___I__ <br /> METER VAWE _ _ _1 I �__ II_._ �L��`_ <br /> __ --_ �-'--___ ( � � <br /> METER NJ_S_.Y.1��___-"__TYPE:�.1.-_;�._L-. — _ _ �� � 7 G- <br /> ✓� C I 3� I - —/ 2"y �� <br /> MET@R BOX CONCRETE� <MALL�� LARGE _ � �_LI SI _ <br /> �__.�_-�-------- — — -- - �� i 65 <br /> ���_:_c-�.�_��c.� - — - ��-�--- <br /> - -���_�,,.�.�.��=� i --i-� � -�'---'¢O- <br /> `_� -�- �' �i _ I-� -- �Il��,,�`Z <br /> _—�,s�,�.- s:��F _ —I --� �i�a <br /> ,� --- I �— - -i— --�� �-- <br /> �_ _ <br /> .,,., <br /> DATE INSTALLED: � I �L�}.-p ��-J. '�UB TOTAL /�`� �3 <br /> / `/G-- /f �—� _._:;% l � / . � s <br /> CO�E � LABOR ANO EOUIPMEN�flENTAL � I i'J�R� RATE � <br /> � � �, J��»I2o 3/ <br /> � _ � � <br /> --� - -- — I � <br /> --i�;, . �� I� ��I'� '� 73 <br /> , —� -- i <br /> � -_ ! <br /> --i�1 ,- _�, I �� ,�== 7 I oc <br /> ---�-= ----------- - - �— - <br /> , I <br /> ' �; <br /> �'I----- -- ---- - ---- , --- <br /> TOTAL I� <br /> REMARKS: � —� � <br /> .._--. S � �. � �.�'f .i� � ._�C�"_ /�"" " �=1 � -. ___. __ ___"_ 'J - <br /> ✓. � � <br /> � , ( l� .i -�"_ . ___ <br /> j' ��/'r ... - . � , . .�. . ,., . � i - � . . � n . ' .. .. _ <br /> .__1_. �. . _ . . . .__ _ . _ .. _ __ _ . -- -- ' -- — <br />