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NOP'"� I'S"7 ��7 <br />�FIXED <br />� UEPOSIT s �1��.� <br />APPLICATION FOR SERVICE <br />CITY OF EVERETT We1TER DEPT. <br />SERVICE N� 2331 <br />oRoerx <br />DATE �Q I ( � <br />__ -- __'19� <br />� <br />SERVICE (BY ADDRE66) � ��t_ WV 'v�O2` / � Q L/�l.l(ZLZ <br />� _BLK. �-Ii LOT_J_._ADD._�v\�,il.T.N't-S- <br />� OWNER�QS-�LLv�S��CZ-S-_ -__— <br />.-CONTRACTOR_____ <br />LA <br />I INSTAL���, M�'TEREDSERVICE_____.____ �---...�..-- <br />I i HENEBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE �� � — <br />I ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING � � 7 <br />OR AS SAME MAY BE HEFEAFTER CHANGED. <br />/ 1� / <br />61GNED:��•�_� I.I Qi� �_- __- 7� _�t�J� <br />MATER�AL9 �/ ItL � 1 IN.'i 2 �N. � .. - <br />� PHICE AMOUNT <br />� PIPE COPPER 1- - ��� I <br />__ —�, GALV_.. STEEL � <br />� CORPORATION � ��- <br />� CURB�- oT _--- —. ._--.--' _ '__'_ — <br />� —'_'—_- ___'_ _ I I <br />� SERVICE BpX PLASTIC_ G 1�:�THf'�— / I I <br />� METER VALVE —�— _. <br />_'-_'____ _ <br />__.'_ _. _ ____ . _ <br />' _ -_-__—_--' <br />i METER No. I --- �--� -- <br />—_ <br />.� <br />j Mr ETEIi BOX CONCRETE �_ _ SMALL. .LARGE --- <br />i 3���i—T_-3�T_.4P Sl.�vic..= l I I I I <br />� DATE INSTALLE�J: <br />cooe <br />I �_.. <br />��:I �:q " . ��:. � OFF <br />LABOR AND EOl11PMEN � RGNTqL <br />SUB TOTAL <br />HOURS' RATE <br />II _-._.._._-'_ ____ I_ <br />� _ �-- � ---- _, � - <br />� -���_� � r- � <br />�--- � ���"-`=- _ _ <br />I_ i -- �' -�`=-' � /----_-� - <br />- ---- ---- _ �. _ i z <br />-- �-- -- <br />� � ---__ - - - - �3�-z- -- - -� -/-- - <br />, <br />--- . TOTAL IR I <br />REMARKS: �' � � ,.�� , J - , - <br />. - . ., <br />_-. ___-_ ___ , . . '. � <br />_ __ -___-- _ _.. .�. . J__- . - <br />