Laserfiche WebLink
CITY OF EVERET'F A T `ER DEPT. <br />APPLICATION FOR SERVICEAND/OR TURN ON - SHUT OFF ORDER <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE ORDINANCES <br />AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING OR AS SAME MAYD_ <br />HEREAFTER C..IANGED. <br />DATE Q/� 19`' <br />TYP BCD NO. SUB T <br />Y57 <br />REY' <br />SIZE <br />UNITS <br />7'I RPPLIUTII ®TUflN.ON❑ <br />SERVICE ADDRESS .271 <br />OTHER <br />OWNER ❑ <br />TENANT <br />CONTRACTOR— ADDRLSs <br />RECEIPT <br />NUMDER <br />SIGNED:✓� <br />FIXED AMOUNT �0 PAID k- <br />EPOSIT REECC}1VED <br />�'✓i) ((LI/lAY L.I(�' <br />SERVICE <br />ORDER NO. <br />BY —_ <br />WORK COMPLETED <br />APPLICATION NO. <br />41?q <br />OREMAN <br />