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APPtL�l�� 7 / SERVICE <br />No. (�,- � y CITY OF EVERETT ORDtR NO. �� �' <br />APPLICATION FOR WATER SERVIC� <br />�FIXED DATE_���� —_'19� <br />� DEPOStT s �Z�� � � W. O. <br />No. __— <br />SERVICE �er �oueus����� U�S7���i5l.1) 9LK._ LOT , AOI�p�� <br />OWNE� ��.L�r1.����TG CD __CONTRAC70R_ __.. 3 <br />F <br />INSTALL�' � ` METERED SER\9CE_—_ _ __— _- <br />1 HEiGBY r.P�LY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINAl�CES AND POLICIES OF THE WA�ER DEPARTMENT NOW E%ISTING \ <br />� _ — <br />OR AS SAME MAY 8E HEREAFTER CHANGED. eicHco: -_��'__ �L ' __. __ _ _ <br />M�TERIALB 11i IN. 1 IN. � 2 IN. I I PRICE j� AMOUNT <br />plpE <br />GALV. •- STEEL <br />CGRPORATION _ <br />CURB COCK OT <br />SERVICE BOX PLAS7IC •- C I <br />METER VALVE <br />METER Ko. (,C �S� .. � TVPE:C'IfR(:N_I_ <br />._. _f _ — — _ _ --=-�1 <br />��dETER BOXI_CONCRETf��'�y��_LARGE <br />�' _� ' <br />DATE INSTALLED: /Z �� <br />COOE <br />I <br />-'- - <br />� __ <br />I <br />-� --- <br />REMARKS: <br />] <br />�Z'��_�I_ <br />� ON <br />7 � � OFF <br />SUB TOTAL <br />LABOR �ND EOUIPMENf RENTAL MOURS <br />� � .�l � I � <br />_ __� _" _ _ - __ -_- _._F ���.� !Z�'fG�l- / _- <br />- - -- - - --r%�_3._� / -- ' 7-- <br />G% �� --`�'' �� -i 7 <br />- ,� G ----. ��� t� -�'-3 <br />-� --- - <br />RATE <br />TOTAL <br />