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r <br /> � ' <br /> r <br /> 1 <br /> 1 <br /> r � <br /> SERVICE �� �� �:�� <br /> APPL. �j� CITY OF EVERETT oaceR N0. - � <br /> No. �.3.�J/ APPLICATION FOR WATER SERVICE o��� � � � B p+n <br /> � �� <br /> FIXEO <br /> ❑ d� W.O. <br /> � DEPOSIT s_�+O __ No.---/� — n <br /> SERVICE �er��i op�nces� <br /> �O� � �[t[✓--CG�BLK...__—LOT_S�\—A(Do.^—"t��/✓`L <br /> OWNEe:"".J�L..� _'.v.i."Gr;�v:,—) _ __ _--CONTRAGTOR_--_— <br /> n �� __ - " <br /> INSTAL '3�—METERED SERVICE__— -- -- --- <br /> 0 DEN�NCES AND POLIC ES OFETHF. WATER DEPAPTMlNT NOWWEX 5 ING . ._ __ <br /> SIGNEO: X�— �— _ <br /> ON AS S�ME MAY BE HERE�FTER CM�NGED. �MouNr <br /> EHUL6 I ii IN.I 1 IN. I : IN. � i I PPICE <br /> PIPE COPFER--GALV...57'EEL I�"_III�_�_'I_L� — " -- <br /> i <br /> CORPORATION _'_ ---- _--.—... .. —I — I <br /> CURB COCK �T �I <br /> ___ ,� ' — <br /> SERVICE BOX PLASTIC'�•- C 1 -- --� <br /> _—— <br /> METER VALVE <br /> --_ _— <br /> .___._ —_-- __' <br /> METER No. .� . .. � � TVPE: I `* ---- —' <br /> METER BO% CONCREIE SMALL _LARGE -- — <br /> —_--- _ I �I_— <br /> —_________ —__._'_._.__ I J—I__ __ —_ <br /> — _ — '_'_ _� I .__' —_ _ — <br /> I —I— __ —_ <br /> _- ___— . . --_. _ _.___ .__ I—II I� I�I ___ <br /> __—_ �I <br /> '� � I ON <br /> �OFF SUB TOTAL <br /> OATEINSTALLED: 7^ � - � <br /> v � �wuns n�tc � <br /> COOE i LADOP ANO EOl11PMENf RENTAI ` I �� �� i. <br /> � . _. JeeJG_— — —_ i <br /> _ —_'_——___—_ _ . _— _ __--_--_ . `aV'QI"1I '� -- � <br /> ' .�y� _ — -- _ <br /> —', ' —�— '-f'ri�� _I _ ,� _____ — I <br /> —' — _ /�(� �3 /0% -_=�.3soy_�_ _ ,�_ _ , <br /> 1 <br /> -----�-- <br /> --- — <br /> _ _- - <br /> - <br /> -- - - - <br /> - <br /> —� ----- - ---- — �-- --- <br /> __ � TOTAL <br /> REMARKS: _- .-----------'— <br /> L -� <br /> � , , <br /> � � <br />