Laserfiche WebLink
� <br /> NaP .��'yC�� CITY OF tVERETT OR[IERE NO. , <br /> nPPLICATION FOR WATEH SERVICE <br /> �� � <p<� <br /> � FIXED DA7 ���_ �'�--18!_/- <br /> � DEPOSIT ��j� � ryq�' _. -_ <br /> SERVICE lBv/,�p/�nE ��(hZ-�4�e%�n . _--BLK.�G72�_LO'���_����.- <br /> �� <br /> OWNE � . _ _L�jGX� ___CONTRACTOR_ -- -- <br /> �/ FLAT�--- � <br /> INSTAL�—�METERED SERVIC - - -. --- ------- - -- <br /> I NEfiEBY APPLY FON 1HE ❑SE CF WATER IN ACCOROANLE WITH THE n <br /> ORDINANCES AHD POLIQES OF THE WATER DEPAHTMENT NOW E%ISiING � , (/ ��.�� � <br /> OR A5 SAME MA'/ BE MEREAF7ER CNANGED. 91GNEO: X N-Cr✓- ..'Q �'Ci•- -- <br /> - MATEP14L5 S'� IN.I � �M. 'i21N. I � PHICE AMOUNT <br /> PIP� �:�{��?'C-� COPPER_ GALV._-STEEL _ (_� I I <br /> CORPORATION --���-���-� � —�I _ _ . <br /> CUR9 COCK OT � ___ __.. <br /> SERVICE BOX PLASTIC -• CI I _ _ __ . <br /> METER VALVE �J C�- � '� � - - — <br /> _,.{�� �.. <br /> METER No._ 'J�.J �� !�aYJ"� TYPE � �- .I.�... { _I�__�' �� __ __.. __ _ <br /> METER BOX CONCRETE__ __ SMALL LARGE _ I_ _ <br /> � ��—'� .)l � r� �> _--_.._�_'—_ — �� II —�—i . <br /> %1 �� \I"� , '�� J��.e�� '�.7 ; � ��« I ( <br /> / A � .. <br /> 7 L;�.-L .�o-+.�-_. �� —�_- <br /> ' � � <br /> I ' Y %e �'.;....Q.� y����.�,u-ca — – <br /> �,1---�- , ; ;• �a ,•/:. ' -�—� - --- f I - ---�-- <br /> =� -�---� — ------ - -- - � ' __ <br /> . � ON I <br /> �ATE INSTALLED: �„Z �7 � I � OFF SUB TOTAL I - <br /> COOE I L�BOR ANO EOUIPMENfRENTAL I NOUPS RATE <br /> - ��. � ���'-i �--. � � .� __- - _ <br /> —, - ------ - . _ .-----�----���1��_l/_1J- I—V— -- — - -- <br /> _- - �{k-� I1 ��.- - - - - <br /> � - - -- -- <br /> - t y _I_ � - <br /> I <br /> -- ��-�� -�� , --- -- <br /> � --------- �- - - - <br /> -- - -- - <br /> ------�---- - - --_. <br /> -- --- - - - � <br /> , <br /> TOTAL � <br /> REMARKS: _._. _ .. ____' --' --. '- <br />