Laserfiche WebLink
NoPL '✓ �(r./ APPLICATION FOR SERVICE SERVICE j�J� �Oi <br />/ �'�� � �%J / <br />CITY OF EVEREI'T WATER DEPT. oRoeR <br />� FI�ED DAT�`� �/ 1�=7� <br />(p( �EPOSIT S`� 7 G`/ tV. O. / <br />l� ����' No._ <br />% ..� ^� �j�� / - <br />SERVICE�BVAD�R[561—__�� �-'����_jJ_�,.�/ � %'%2'it'tG�/O�yK� LOT__qDO._/77���_ <br />OWNER______ _CONTRAC70f2S��ti_ � .�p�(_�J .��.._f-y <br />''J �� _RYIIT —__�. ��C'O(P "! ���,.�_� <br />INSTPLL '� METERED SERVICE--____ _ � ��/ � <br />z _t_�.r <br />1 HEREBY APPLY FOR 7NE USE OF WqTER 'N ALf.ORDANCE WI?H THE J <br />ORDINANCES AND POLICIES OF THE WATER OEPARTMENT NOW E%ISTING <br />OR AS SAME MAY 6E HEFEAFTER CHANGE0. c�¢rveo:X �t�C _� _N +�t___ <br />' idATEPIALS I i IN 1 1 IN.'�,. 21N. � PR�f.E � AMOUNT <br />PIPE _ COPPER --�GALV�.. STEEL _ � 7' �� . �� ��' <br />CORPORATION + I <br />CUR9 COCK OT _ I � � <br />SERVICE BO% PLASTIC - C I I I <br />METER VALVE <br />METER No.��_:J��.'J � .•,:.y�" TYPE� �--- - �7 <br />--=-L:-:-'.-�-IL%`_�r..ui.cL_._ I_ '' � � /� /'J <br />METER BOX CONCRETE SMALL LARG _ / --� "�/ IQ� <br />_ �%�• r�c('�n...,. :�',r� I / I I /�JI / � <br />_i.._,�6ui�.,,..•,YJ..E:,. � / � �� /4;3//- <br />DATE INSTALL[D: <br />COO[ I <br />0 <br />HEIdARKS: <br />I ❑`ON <br />� OFF I <br />LqBOfl ANU EOUIPMEN�RENTAL <br />SUB TOTAL <br />HOURS I RATE <br />TOTAL <br />