Laserfiche WebLink
.,, <br /> APP �(� � CITY OF EVERETT SERVICE � � � <br /> No. ORDER NO, � � . <br /> APPLICATION FOR WATER SERV�CE <br /> � FIXED DATE_,Sr�_.�DZ� <br /> DEP091T f $: 3S �—� W.n. <br /> ❑ __—_— No.____'_—___'_ <br /> SERVICE fevAODREce1—��L-��f�� _.—. .BLK.G��_LOT_��!_ADD..('1��LlL��r�f¢f� <br /> �/� �J`g • /� e�'�✓rt- �./ �2Ga Y <br /> OWNE�"✓-"uG...'sr/y�'FG�JL�-�"��--._.__—.__-__.CONTRACTOR.__.._—'_—___.._ '___— _—'____'_'. <br /> � FL93�_'—�_ <br /> INSTAL� A(E'fEREU SERVI�E�"' -. --_---- —__—__---_ --_—'_—'—___'__ ._.__ <br /> �—�_—'_� <br /> 1 HEHE9Y APPLY FOR THE USE OF WATER IN ACCORDANCE WITN "HE <br /> OROINANCES AND POLICIES OF TiIE WATER DEPAF:TMENT NOW EXISTING � Q� il ' �_ — — <br /> OR AS SAME MAY BE HEFEAFiF:t C/IANGED. slcH[c: ���.� �� _ <br /> MATERIRLS Si IN.� 1 IN. � [ IN. PpICE JI .�MOUNT <br /> PIPE COPPER-- GALV.--STEEL ` � _ � <br /> _ .—_-__-- _.____'_II �`— .�� _—_' _� —'_ <br /> CORPORATION __._"______'__'_I I_ _. . I___ _ ' ___ <br /> CURB COCK C'T � - <br /> SERVICE BOX __ _PLASTIC - C I_ I II — � � <br /> METER VAWE � •� <br /> _ METER No. — ' _ ' __ _ . _.TVPE.—_—. __ .I `s _� _'__ _� '—__—_ _ __ _ <br /> _ '_ . _. - __ _—__ _ . _. _ . . i �1 <br /> METER BOX CONCRETE_ __=�MALL LARGE__ ___i__ _ _ _ __ <br /> , .- ;_` _— _ —I I . — _—.. <br /> - ���—� + _�,�— — — <br /> --�- -.��' i-'1 I -� C_ - -- - : <br /> - --- - ��? -- - �J�-'- -- - - <br /> ��✓' 71.��� c; C'_ I <br /> , JN r <br /> OATE INSTALLED: I O OFF (�� SUB TOTAL -. <br /> COOE I LABOII AHD EOUIPMENf HENTAL NOlIRS RAtL <br /> I I I <br /> _—I -___- _-- ________—_I -- —_ ... <br /> ___—i -__— _ I --- — <br /> - <br /> -"_-- __ . _ _ _—_--__.-_ _._.____ — .. <br /> ; _�_ � a - ;--- _ -- <br /> -��� �, <br /> -�------ ---- - - _ _ <br /> -- - �- - -- - <br /> -��- --- - --- ---�--- -- - . <br /> TOTAL <br /> REAIARKS: <br />