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A''�'�-• ` �W� � APPLICATION FOR SERVICE SERVICE No ]$ !} <br /> ORDER <br /> N^��_��' CITY OF EVERETT WATER DEPT. �i, .� �,� /y, <br /> d FIXED r�. DATE �g'„__ <br /> � DEPOSI'i 5 /�� \N.O. <br /> — � , No. _ <br /> ����l�i %,-( V 7Z-i C�� / l-��i(• / ; /� /_«'7`_.�`' _/ <br /> 3ERVICEIerwooncse7 �� �� `BLK. I_07/L./ADD. <��{ <br /> OWNER —_ CONTRACT �/�_y������` L�L<-- -�y�'i <br /> INSTALtL�/U FLA��a SERVICF 'I / <br /> - i — <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE � � <br /> ORDINANCES AND POLICIES OF 7HE WA7ER DEPARTMENT NOW E%ISTING <br /> OP. AS SAME MAY DE HEREAFTER CHANGED. BI.rvEo:X �_ _ <br /> MMERIALB I � IN. 1 IN. I 2 IN. I I PHILE AMOUNT <br /> _ PIPE COPPEB•- GALV.•-STEEL ('Z,f �� I I J(C <br /> CORPORATION _ I I <br /> CURB COCK OT — —I � � <br /> SERVICE BOX PLASTIC •- C 1 � I _ �- <br /> METER VALVE <br /> METER No. TYPE: I cq <br /> METER BO% CONCRETE SMALL LARGE I <br /> - --/�' - ' -� ��� <br /> � - � <br /> -- -�I _ -_ I <br /> I I I I - <br /> � ON <br /> DATE INSTALI.ED: / � / // � �` <br /> r 7'� �J I �flFF C'� . I�'�_ , SUB TOTAL Id <br /> COOE I IABOR ANO EQUIPMLKT R[NTPL HOUNS RATE <br /> I <br /> I ln� % ,,. R��P �/� �� � �' ��� II _L- <br /> , _ �— --;, I <br /> ' - - � - --�; i <br /> - --'- <br /> � i <br /> - - ---- - - - -- -- --- �� <br /> il I I <br /> L:/ Torn�� � /`/ h% <br /> FEMAftKS: "- .:l � ; �F !'/� U JF'� � � � ._-_'___'./� L <br /> � !� �! L1.L��__l <br /> -- — <br /> � <br /> ��:���ii�� -_ ��. _ �>_ _ � �_[,� �- „ �,, ,. � . . _, <br /> - - - --�-- <br />