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ryoP'�'_x .�i�/ �� CI'fY OF EVERETT oaoe�RE NO. , . :• :) <br /> AFPLICATION FOR WATER SERVICE �1 [J �Q <br /> � FIXED DATE_%��J---_19" <br /> � DEPO517 S 3OG �' / NpO. <br /> �j ///// � �//J spiso (y_,>>� r/_= /9-"—a� <br /> 9ERVICE �ev DP[es��(J.Gi��._�,�_�1��L!"� BLK.. LOT_ ADD.—�J _ <br /> // <br /> � OWNER ��-��LCC "�'� ._ CONTRACTOR___________ <br /> � �� FLAi—'�` <br /> INSTAL�_;� �'rdETERED SERVIA�E__ __ _ _ _- _--- __ ___ <br /> / ___-/_' <br /> I HEREBY A PLY FOR THE USE OF WATER IN ACCORDANCE WITH THE ��� ////l/�/i: //� <br /> ORDINANCES AND POlIUES OF TME WATER DEPARiMENT NOW [%ISTING /�1`=-CS''-'-/� _t�//'�' „f G <br /> OR AS SAME MAY BE HEREAfTEN CMANGED. sicr�co: XF � �i'� �-�i�_ __ ..______ <br /> � - MMERIAlS �' IN. 1 IN. � 2 IN. � �i I _ PR� AMOUNT <br /> PIPE � , . .. :�i ('� COPPER -- GALV. --STEEL �7 I_I li <br /> 1�—I_—,._I _ <br /> CORPORATION _'___. ____'_�1 � 7E��� � � I _I_ � _ ___ __.__ _ <br /> CUPB COCK OT � I <br /> SERVICE BOX PLASTIC -- G I I ' . <br /> - —__ _._ -.__ .. _- _._ __ . _-- . _ _ - <br /> "l-_ - . ___ —. <br /> METER VAWE :<_ .�1�.� -. - . -_ � - . . -- --- <br /> METER No. � ^'� � TYPE � ,. -;. I )S � <br /> _U — r .y_ _ <br /> METER BO% CONCRET�,t,���`� fi �L LPRGE l !__,_ _ I. __. . _ .._ _ ' <br /> �., l - I' � � � <br /> `/ i _ i � -- --- _ � <br /> -- �� P - ;- -- - - � � �-7 _� <br /> _ - -�-I ; _ - l>' ; <br /> - � - - _ /_ -�-- - -- <br /> - --- _ -�. _� � -- :. <br /> - -- � - ,- - <br /> � I <br /> � ON <br /> DATE INSTALLED: �� � .� � /7 y � � ppp SUB TOTAL <br /> COOE I LABOR �HD EOUIPM[NfH[NTAL HOUFS RAT[ <br /> _' � � � I <br /> � - 'Q�_.� / ! <br /> . ____-- -- -__---- .__ _. __ - _ _- __ ' ..L_-_"--� __ <br /> r-`- <br /> ���.L <br /> - - -- " 3 -� <br /> � _. � � _ � - - <br /> -- <br /> �-� �' -(�' - ,,' -- -- - <br /> _ .-r-.� � � <br /> -____ - _ _ ; <br /> _ �r � _iv� 7' �v�� � _ - _ - - - -- <br /> --�-���� i � -; : <br /> TOTAL • <br /> REMARKS: <br />