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ArPL. SGNVICE <br /> N,. 29y�� CITY OF EVERETT ORDER N° � � � � <br /> APPLICATION FOR WATER SER ICE' DATEJ���___to__ <br /> �xEo �/���� <br /> ❑ oEro.�T �,�- TO PpSTING---3=z-��-- W.�. <br /> No.____ / <br /> sERViCE ur soe�u�)�11L�-1 L/W �� C�BLK.. LOT���_ApqL}��Q� <br /> OWN[.^ ��� n��-d5'=�-«.,�/ CONTRACTOR .__-_ <br /> �FLAT _._____ ___._-- <br /> INBT�� � 1��VICE—.- <br /> I MERElY APPLY FOR TME 115E OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE W�TER DEPARTMENT NOW E%ISTING <br /> OR AS S�ME MAY BE HERE�FTER CHANGED. •IGr+Eo�_.__.________. ._ . _ ____ <br /> MI1-UI�l{ jf� IN. I iN. � 2 IN: � � PRICE � AMOUNT <br /> rIPE CO?PER_GALV.-- STEEL I � _ <br /> CORPORATION _ _ _—�—� � � <br /> CURB COCK OT _ ___ _I I I—_ � <br /> SERVICE BOX PLASTIC •• C I I <br /> ME7ER VAWE �� <br /> METER No. /,�O _TYPE:�{/�CJ�'�-_ V___ _ __ ' '_.-- _ - __'_ <br /> METER BO% CONCRETE SMALL LARGE � <br /> ' _-. __ _ .-__- _-_'_ '__I_ ___ -_ -'_ _ <br /> -__ I__�II_-__ <br /> _—I' J_l,'__ —' — <br /> ii <br /> ' _-"__I__ �_"i- _ _' _ _ <br /> - ___ I— �_I_ __. <br /> DATE INSTALLED:/ - / i� L/ I � OFF / I SUB TOTAL <br /> v� <br /> COG[ � LABOR AND EOUIPMENf RENT��.� MOIIR! RATE <br /> i�l./�l �/(1 — - <br /> -- ----- --I <br /> � --- i — <br /> — ------- -- — ,-- --- <br /> � <br /> i ---- ------NO ACTfON--�-- — <br /> Will be taken on servicA� <br /> � --- — — — <br /> i <br /> TOTAL <br /> REM—AR�JGL('iW`�(�/ �/�7 _ __ __ <br /> / <br />