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APPL, j�J S� CITY OF EVERETT sERvice - <br /> No � ORDER Nl�. ' <br /> APPLICATIOfJ FOR WATER SERVICE �- <br /> , DAT�'i� � �� _,s.�— <br /> � FIXED ��, ✓ <br /> DEPOSIT CV � W O /� <br /> ❑ s�_—. No. <br /> • �J�'.1 � /�iY.-�-�'!.� 0� �:"�^, 'r'Cl`t� <br /> SERVICE (BY/wp DrE88) � / BLK . � LOT/,�- �� , <br /> OWNER_�G."�-�-�--G--1='T�-�-------�--CONTRACTOR --- <br /> �� FLAT_ <br /> INSTALL-LV ETERED SERVICE---- - - ---- <br /> ��-_--__ <br /> I HENEBY APPLY FOR THE USE OF WATER IN ACCOfiDANCE WIiH THE (' <br /> ORDINANCCS AND POLIGES OF THE WATER DEPARTMENT NOW EXISTING gi�rveo: % � ---"�� �----- <br /> Ofl AS SAME MAY BE HEREAFTER CHANGED. <br /> MATERIAlS �/ IN.� 1 IN. 3��N. � � I PA�CE MOUNT <br /> d /� �/� <br /> PIPE - .Gl/.STI`/ '�i-YT"ST-EE4---R I_-- II <br /> CORPORATION -�-- -I — � � ' <br /> � - ' — <br /> CUPB COCK OT ______. � —I I— — <br /> SERVICE BOX PLASTIC •- C I _ _I _ — <br /> METER VAWE ___ _... - _ �- ---- - __ —_ -__ <br /> METER No. �' rJ�_r __ TYPE:�G�I jf�(J1`_ '"_�_/' — <br /> METER BOX `��'��57 .MALL) LARGE _ _ _ <br /> ��) Fd,r���4r—�.2� _ _ � l I_—�— — <br /> ��-7�`�=o "��'iN_l_��D� � — <br /> �1ti1#G—�-- -- _ -----� �—1 _ — <br /> __j�_-/�lJ� ,s - - — � — <br /> #�= /�7 SnC.c�J'L��i��:_�/-�—--i—I� � �li — <br /> • `�/� / �/ I �ON / � <br /> �f� � SUB TOTAL <br /> DATE INSTALLED: OG�i� y � � OFF '� <br /> COOE I LABOR AND EOUIPMEN f RENTAL � I <br /> HOU S RAiE <br /> I _. _ _" �JJ � s <br /> � __ ..y _��- � —' <br /> I 7 �� -_�"_� -I. - -__- <br /> � -��,_� � --- -=�� - - <br /> i -- ----- -���.-� -- -- - <br /> _ --- ---- -�-g°S��- - -- <br /> --- TOTAL <br /> REMARKS: . .- - ---- � <br />