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NOPL L�p�D7`1 CITV OF EVERETT SERVICE <br /> APPLICATION FOR WATER SERVICE ORDER n�p 5460 <br /> KA FIXED OATE_�,L(�./��.��_IB.� <br /> ��1 ,CS W.O. <br /> � DEPOSIT � No._ — <br /> $ERVICE (lYAODRE��1�_�P V�uA1j �J�� "'� 1 BLK... LOT�AOU. <br /> OWNE ��{Q� CONTRACTOR �m� — <br /> FLATl <br /> INSTALL.��� LPERED SERVICE_-- ///'''��� ------- <br /> I HEREBY APPLY FON THE USE OF WATER IN ACCOPDANCE WITH THE t� �� <br /> ORDINANCES AND FOLICIES OF THE WATER UEPARTMENT NOW E%75TING (�.�i� ( <br /> OR AS SAME MAY BE HEflEAFTEft CIIANGED. etcHeo: X __ -------�— ------ �— <br /> MATEHIAL6 � IN. 1 IN. � 2 IN. I I PA�CE AMOUNT <br /> PIPE L/! <br /> ! �� <br /> CORPORATION � _ __ _ <br /> CURB COCK �?T� I _ <br /> @R �CE BOX YLAS7IC • C I I _ _ <br /> METER VALVE _ ___ ____ __ <br /> METER No. TYPE: ___.__ I__`f _ ____ __ ___ _ _ __ <br /> METER BOX CONCRETE SMALL LARGE __ _ <br /> O r9 � /,U ���--- - --I - --- <br /> / ./�?- 7 .� ui�Tf�U�� _-� i- -- - <br /> ,.�/-i.�Z_3__ -�- -�- <br /> ,Cis,s�r,y �� ! —�- —�— -- <br /> 7�—�lf�� �2 �1S��u� c T--� I I I�I --- <br /> DATE INSTALLEO: �_ /b _ � � I � OFF SUB TOTAL <br /> / <br /> CODE I LABO AIJO EOUIPMENfRENTAL NOt1R5 RATE <br /> � _ _ �,�/1 <br /> � ,i—� _ — _ <br /> _! n .���9 aJ-- - ..Z���---6 --- <br /> �� _3,��'f 6 <br /> —� ----- # ���G— — <br /> i I <br /> TOTAL <br /> REMARKS: <br />