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" � <br /> � <br /> �.�i/��3 � ��. <br /> arP CITY OF SVERETT ROfiRE NO. � , - , <br /> No. . . APPLICATION FOR WATER SERVICE �AT� A.� _1e� <br /> � FIXED Oj W. O. / <br /> � DEPOSIT s,�„^�' No. � <br /> / :�' � �� <br /> � BLK._ � LOT ADD._ '� n <br /> SERVICE tev�on esai- . �.,s�� <br /> OWNE , CONTRACTOR <br /> // �Fi-AT—�- .- '_ <br /> INSTA METERED SERVICE, / � <br /> I HEREBY APPLY FOR F"WATER IN ACCORUANCE WITH THE � �///�/Jj,/ ,� <br /> ORDINANCES AND POLIQES OF THE WATCR DEPARTMENT NOW E%ISTING si�NEo: X - -�-Y"--�- <br /> OR AS SAME MAY BE HEPEAFTER CHANGED. ppi�E nrnoUNr <br /> MATERINLS Si �N. � �N. I I I <br /> /� 1 7 / � <br /> PIPE 1"'f(, I �L GOPPER-- GALV.--STEEL _ J <br /> CORPORATION �'F I S OUS — I � <br /> CURB COCK OT —I I <br /> SERVICE BOX PLASTIC -- C 1 — <br /> METER VALVE 1I C,I �3 (� — -- <br /> � IaS� l�7 ISJ- TYPE: P 0.'��I }5 ___ <br /> METER No. � �` -- — <br /> METER BOX CONCRETE _ SMALL LARGE _�i I <br /> y�'Sz,�a w%r" — $=31— <br /> i 5 0 --�—�� — <br /> L 3 Z— I — <br /> 5 clS Sn -- <br /> 1�{ c�o l b S � To a�rS2_ �c� S f°T i �- <br /> �oa ibs � � � <�:X vw� Sfa� <br /> ON <br /> �t OFF SUB TOTAL <br /> DATE INSTALLED: yl � l ( - �I — <br /> lJ I MOURS RhTE <br /> GOOE I LABOR ANO EOUIPMEN f RENTAL - � <br /> I �n`�{1-I- <br /> -- IJ:fl�l I� l' _ - <br /> _� � �� ( ���� _ <br /> _ f � ��--- � 3�3 I 7 �' -- <br /> ; �� <br /> 26ZI <br /> I_.-- <br /> � <br /> I TOTAL <br /> . REMARKS: - ~- <br /> 1 <br />