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�� SERVICE <br />/� OROER NO. <br />/ / 'CITY nF EVERETT �J ? e/ � <br />APP�1�' DATE-Q--' -- <br />��o �"'� qPpUCA7�ON FOR WATER SERVICE <br />r w. o. -- - <br />� FIXtD �% / )` No._---_--� _ <br />L DEPO5IT s.� O C�_ _ // �✓G>.'v''"'c-C� -. <br />/ <br />� _LOT-J�—n <br />✓ ' _ ' t BLK.._ - _ �r,�.Yr.._. <br />�G�YJL- � <br />SERVICE leY �ooR[se�- / CONTRACTOR — <br />/�0_ _ J� -- -_-__ _---_ _. <br />OWNE�/ �i�r..� ��'i� '�--� <br />z�- � <br />' � � � �___--- -----_ . <br />,�..,/ // 'L.i T� <br />y[/_ _METERF.D SERVICE--�- - �y�TH THE <br />INSTALLf �- WATEfl IN ACLORDANCE `�. _ . _ _. . . _ _ - _ .-... . <br />/ <br />I HEREBY APPLY FOR THE 115E OF WATER OEPAHTMENT NOW E%ISTING 8 GHEo:X I pq'CE A OUNT <br />OFD�NAN�ES AND POLICIES OF THE . I <br />_� � c�uF MAY BE HEREAFTER CHANGE=� 1 w N.� ��H.IZ�N'�� <br />r �_ I <br />COPPER - GALV. •- STEE __ i - —� <br />PIP= __ ___-" � � I <br />CORPORA710N _ __--- --- <br />_ � � <br />� or —_—�"' I �— — <br />CURB COCK _ �^- <br />--�-_ PLASTIC�• C � I _ � <br />SERVICE BO% �J �I- — <br />�� � .. . - -- I�_---_ I <br />_'_ — <br />METER VA�_ -___ ... - __ _ _- _ -__ ' �� � I__ <br />TYPc: -.-�- <br />METER No. --- � SMALL LARGE _ ---� <br />n1ETCR �OX CONCRETE_ __ ___ .-_ _-_ I —��I__ <br />_ D.T_,_ __ -- -- � � _I_ <br />-- --- _ _ --� __ <br />_ _ -- � -- <br />- _- -- --ii -�� �,--� -.�--� <br />- I ��-ryy pN SUB TOTAL <br />"r, OFF q�1E <br />7 7 NOURS <br />OATE INSTALLED: Lr/.- `-r � �- <br />L�B�A AND EOUIPMENf PENTAL /�� -I N_ _. �- <br />- - -- <br />C H_,_' <br />-- c�F�r�v�--I �— — <br />cooE <br />--� — "_ ___ /// — �2f?- I `�------ <br />�--II �-..�/( / ��___#���—�I 3 -- <br />/ � — <br />-- --- - .. .----- � I _ <br />�_—��- - --- ---- - --- �- I -- — <br />�� TOTAL I <br />REMARKS: _ _ . . - - � � �_� � <br />