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, <br /> APPL. �9� 9D APPLICATION FOR SERVICE �RRDVICE N° 5 5 <br /> "°. G p CITY OF EVERETT WATER DEPT. /��}� � �y/ <br /> � I / � /� DAT E���1��`�1�7_ <br /> � 1%ED O <br /> DEPOSIT s � DO,� N°=l_�� �3 3 <br /> � �� S� 02 - T�?ti j k'. SEu��i . <br /> SERVI �ev�o.o}nw�i � � � BI_K. LOT ADD.--_- <br /> OWN�'"' - "- �� —CONTRACTOR._ — <br /> J � !� <br /> INSTAL�METEREO SERVIcr _ <br /> I HEREBY ApPLY FOR THE USE OF WATER IN ACCOROANCE wiTH TH.E' , /. �' �� •���(1/%- . <br /> OR�AB S�ME M�Y BE��HERE FTER CHANGED.DEPARTMENT NOW E%ISTING 61GNEO:X_ru_�1-~ Z ��` _ <br /> MATERIALB � IN. I IN. � 2 IN. � / PNICE ��--•--M��OUNT <br /> p�pE COPPER- QALV.••9TEEL I �� <br /> CORPORATION I J iI — <br /> CURB COCK OT —I -�? � <br /> � I <br /> SERVICE BO% PLASTIC -• C I � .I� <br /> METER VALVE — -------I�— , <br /> METER No. �F//y- y L•�I�_J_3�TYPE: II-c K�..i_ I '.f —_--. _�. — � i <br /> i <br /> METER BOX CONCRETE SMALL LARGE _ _ � �I <br /> I _ <br /> — I— I I <br /> �— __ <br /> — _—_ —� — — <br /> i I I <br /> � ON <br /> DATE INSTALLEO: �1- �� �7 �'�OFF gUB TOTAL <br /> cooc <br /> I LABOR ANG EOUIPMFNT NENTAL HOUPB RAT6 <br /> � <br /> i � �,�� <br /> - � I 'I � - <br /> - - ------ j ;! I <br /> _' --- -------�_ �i-i <br /> � --------- - � qq�J <br /> -�— I TOTAL -/-/ /I8d <br /> REMARKS: __.---------- ' <br />