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. i �� . ' % <br /> SERVICE ' : �1 <br /> NOPL � -�`� � / CITY OF EVERETI' oROER NO. � � �- <br /> APPLICA'lON FOR WAT[R SEHJICE `/�.r",/� � <br /> DATE-�-Y�--1� <br /> �-i FIXED <br /> M' W. O. <br /> � DEPO5IT s ��_ / f No.---- — <br /> > > <br /> • �5 _- � � � � �, ��keu,�e�J <br /> sERv�cE �er,soonces�—__.�-�_'�'��SIJ[Y �_2�.�.�—.�� � �- noo.— �'�� <br /> BLK._�J -LOT__`�- <br /> � � )"� � �i .�/ � � C <br /> OWNER-=L1-��-1C�,`�� ���-'��JC�/1�/>>__CONTRAC7oR__�.�-�-M-�=- - <br /> �J� / `L� <br /> INSTALV"� ��-'�ICEi -.- - _ ____.-- -. _- _- <br /> ���� <br /> I HEREBY APPLY FOR THE 115E JF WATER IN ACCORDANCE WITH THE <br /> ORDINANLES AND POLICIES OF THE WATER OEPARTMENT NOW E%ISTING eicHeo: \ - ---------�- — <br /> OR AS SAMF MAY 6E HEflEAFTE�t CNANGED. - -- <br /> M6T:AIA1.5 � ��� � ��' I � �H• I I PA�CE AMOUNT <br /> • I I � <br /> CIPE �� Q�f _ COPPER --GALV.-_STEEL'__ _.I__._ I _ <br /> CORPORATION /-J �SO77 --- -' — <br /> . -_—_—' li I <br /> CURB COCK OT _ _ -- - — <br /> SERVICE 90X PLASTIC -- C I_ _ I I_ <br /> METERVALVE � VC � � _ __ _ -- �---{II----- -- -- - - --- <br /> METER No._7C�✓__PIUS��C TVPE: r7G��?�' I _ I . -�7__ - -- <br /> METER BOX CONCRETF.lIJ�( �L SMALL�LAftGE ^ _,_ I _ ____ _ — <br /> .� /��Q% 5 -- - — -_ --- �— I —�I <br /> �. > � -�� ---- - I —I— -- - <br /> _I �_ _ <br /> � �- — <br /> -- — — -- ---I I <br /> _- -�- - —! � I I <br /> � _ "___-'__ _ � ON <br /> FJ� 7 r �-}{_?, I OFF SUB TOTAL <br /> DATEINSTALLED: / ���1 � <br /> CODE � LADOR AND[O�IPMENfRENTAI I HOl1R5 RATE <br /> � ----- - S' �X-� I{� _ <br /> i ��, /Lluor�� �� <br /> --, �� r+i1e5 �ZJII � �, <br /> .� ---1�-- — .�, -- <br /> i � �� -- _ ��3.�- `�'-�I _ — — <br /> —�— -- <br /> -II �-- � I TOTAL <br /> REMARKS: -.. . __ _. . .__ _.__._-'—_ <br />