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APP��/�O APPLICATION FOR SERVICE <br />No. �f4 <br />CITY OF EVERETT WATER DEPT. <br />� FIXED � / <br />� DEPOSIT �y� j • 00 <br />�,20� �C�N 5/• —OLK.J—� <br />SERVICE lBY ADDPEe6)— n s . <br />OWNER-���� ��J--�"--�'--/`� ---CONTRACTOR <br />� /Q___METERED SER\'IGE---- <br />INSTAL � <br />I HEPEBY APPLY FOR THE USE OF WA1'ER IN ACCORDANCE WITH THE � <br />ORDINANCES AN� POIICIES OF THE WATER DEPARTMENT NOW E%IS71NG 6,cH�o:X <br />OR AS SAME MAY BE HEREPFTER CHANGED. <br />MA�lRIAL9 `I �=• I 2 IN. I <br />�� II <br />PIPE �O� P�'ER� GALV. -- STEEL _ �y) I <br />CORPORATION -� � <br />- ' _ -_— I <br />CURB cOCK OT - �I <br />SERVICE BOX PLASTIC -•�C I, _ � -- <br />METER VAL\'E _ --� -- <br />TYPE: u — <br />ME7ER No. _ —�-- <br />METER BOX CONCRETE SMALL LARGE • I __- <br />i )n G' i ] n, .. f- { � �. -- <br />DATE INSTALLED: _ <br />CO�E I <br />_�I � _ .. <br />��1I . l5/��� � - <br />� <br />� ON <br />� I � OFF _,.��_ <br />� LABOR ANO E0�11PMF.l�T PENTAL <br />i 3i' 9ll .___ - <br />q�� 1f;�7 <br />SERVICE �`� <br />ORDER <br />%� <br />DATE � - S -� B- � <br />W. O. <br />No.— — <br />�! <br />raice �11 nmour+r <br />�SUB TOTAL <br />HOURS� RAT� <br />� <br />_��/.------- ---- - -- <br />-- - -- --- ,V <br />REMARKS: �� - ---- -'� <br />�CG�� . . .. . .. . _ . _ . . . .__._.__-_-- <br />