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No"- Z�GG3 <br />Tq FIXED <br />P` <br />CITY OF EVERETT <br />APPLICATION FOfl WATER SERVICE <br />BERVIGE <br />ORDER rI0 rj 4 2 H(i <br />DATE�1 GS�� <br />� DEWSIT�__ N 0— <br />�'1 �Ce n ��lct�i 7� <br />SERVIGE (�vAODRu�7—���� -BLK._ �.OT�—F.DD. ���% �-7� <br />INSTALL�.—METGfceu acnv��.c-- �n <br />I HEREBY APPLY FOR THE USE OF WATEP IN ACCORDANCE WITH 7HE � <br />ONDINIINCES AND POLIGIES OF THE W�TER UEP11RiMENT NOW E%ISTING eicwco: X._ <br />OR 115 SAME M�Y BE HEREAFTER CH�NGED. <br />MATEPIALB k IN. 1 IN. � 3 IN. <br />/ <br />PIPE 0(_/jS%�!, _ <br />CO R W RATI ON � <br />GURB COCK aT �.._i <br />BERVICE BO% PLASTI • C I <br />METER VAIVE ___ <br />METER No. T�PE' __ I__'�__ — <br />METER BO% CONCRETE SMALL LARGE _ _ <br />DATE INSTALLED: O�—a3 S� I ' I,] OFF <br />COO[ I LAlOR AND EOUIPMENf RENTAL <br />1/ <br />--��1- �J� -----`�S_Lis� <br />; - ��.39 <br />^ <br />PRICE <br />SUB TOTAL <br />NOUR9 � R11TE <br />TOTAL <br />�roue+r <br />REMARKS: _ --- �- <br />