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�� <br /> APPLI � '!!�:/ � CiTY OF EVERETT SFRVICE � <br /> No. � ORDER NO. ' <br /> APPLICATION FOF 1VATER SERVICE ��, �A <br /> �,' FlXEO DATE/l'!�'h_��-19/d— <br /> � DEPO5IT f �j�� W. O. / — — '_ <br /> _ —__ �i i(Jo..__ -_ - <br /> //�' // /� //�/, � ��p� l'�/ / /��� <br /> SERVICE �t�' �DDRE9e,j(J_L��G-J`J✓""/�. -��i..ti"`eLK._--�OL—I—ADU..�-�-52��(IJ <br /> OWNER�_��l�t-/� �� �-Y.�L .__—_ GONTRACTOR___---'--"__.__—_____. _._' _ _. <br /> � //��FLAi�j-.�-� � <br /> INSTAL��y A�EI'ERED ERVICE�-_. -.- --- ----'-- -----. --./—.--_. ._ _. -- <br /> I HEREBY APPLY FOR THE ❑S�fl IN ACCOFDANGE WITH 7HE � � / <br /> ORDIN�NCES AND POLICIES OF TME WRTER DEPAflTMENT NOW EXISTING i <br /> ON AS SAME MAY BE HEREAFTER CHANGED. si�Hco: X _-____ .__ - .. - <br /> NATEFIAL6 ' 4i IN. 1 IN. i 2 IN. I �i I, PPICE AMOUNi <br /> PIPE ___ . COPPER . GALV.-STEEL_.__ d� __._ _I__I__I_''_ �_ _ <br /> CORPORATION _ _ _ _ . � I I�_ <br /> CURB COCK OT I � <br /> SERVICE BOX PLASTIC -- C I I � <br /> — . . _ __ _ _ �—�_— _' — ' <br /> METER VAWE <br /> � I' _ _- _'_ <br /> METER No. �I_./��---_ _. —�TYP_E:��U�j�'. .I. `9 I ' . ' _-_ __ <br /> METER BOX CONCRET P���� SMALL LARGE I _ _ _ '� _ _ <br /> __ . . _- ._ .-. /_ /�� � _ I I �-- � <br /> _—_- I I I <br /> — —_ _--__ —__ __ �I_ �_— — <br /> .-_ ' .__ .—_' �I— � — <br /> — —_- ____ _ ___-. . ._ _ __ —�— _ ___�—I— .. <br /> fX ON SUB TOTAL <br /> DATE INSTALIED: ( � `�' _ 7� �`� OFF <br /> l.[ <br /> COOE 'i L�B09 ANO EOUIPMENfR[NTAI ' MOL1R5 RATE <br /> ��-���_ 3 <br /> ---- - - -- -- <br /> � � 3 - <br /> --� - - - -- �1�.� � � -� -3- --- -- - <br /> -' ���>��l_�,���-�'--�-3 --- <br /> i � - -- <br /> -- - i - - <br /> '� - - --- - - - - - <br /> --i ; - <br /> � <br /> TOTAL <br /> REMARKS: `;_�.,. .._I�_ _ _ _ � . . . __ . _ _. _ _ - _-__ . _ <br /> —'_ ___ . T�� , . <br />