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� �P � <br /> rAioP 6t ���a CITY OF EVERETT SERVICE I <br /> APFLICATION FOR WATER SERVICE ORDER NO. ,.. � <br /> � FIXED ?3�.0� O DATE��!_L__18F�L_ <br /> DEp051T _�� � $635.00 refunded 4/24/78 <br /> � s � Check 4k6142 rva�_ <br /> �' f� --� �� 2 9' �7�r�, ,2 ry � �— - <br /> SERVICE fev�oo ee) � " BLK._ LOT ADD. <br /> OWNE� , Q/ ,�i `�' -pJ — <br /> � � __CONTRAC70R <br /> � (r FL ..-. — <br /> INSTAL TERED SERVIG _ <br /> I HEREBY APPLY FOR 7HE USE OF WpT�R IN ACCORDANCE WI71i THE -- � � _ <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%IS7ING <br /> OR AS SAME MAY 9E HEREAF7ER CHANGED. sicrve�: X .. <br /> MATERIALS ]i IN. 1 IN. 2 IN. ' <br /> - I I PRICE qMOUNT <br /> F'�f'E �t-/ COPPER-- GALV.--STEEL .51� <br /> CORPORATION � -- <br /> __�lTin�;� ��� 7—irF ( <br /> CURB COCK OT I � — <br /> SERVICE BOX PLASTIC -- C I � - <br /> I <br /> METER VALVE w,• T i�y/�tJ _ T� TF, _ � <br /> METER No. li,�._ TYPE:/�AIJn I `b I � ����� _�.� _-- <br /> ��___--_—- <br /> yMETER BO� CONCRE7 �,(Arnt SMALL LARGF. I I <br /> —�--- <br /> — - — — � <br /> -3�- :14�TE N LJ. �/.� -- - I r---I <br /> - �O o /LjS. C'e/o� n i/,Y —S a c � _i _ — — I <br /> — -- —. .. I — --- �i <br /> ---� � � <br /> DATE INSTALLED; �' ON <br /> y- �7 L'"' �� I � OFF • SUB TOTAL <br /> COOE I LABOR AN�EOUIPMENf RENTAL HOJfiS RATE <br /> � - - - --- -�e��—�—�' -- <br /> — - ../}, J7. ta e/rr��I $� <br /> I — -- <br /> -, �- -1{�-t�--�g-- --- <br /> --I — ���>�---� c!3 Gd' I � _ <br /> � -- - - ------`t--�-'-s i�- <br /> _� ---- --�- <br /> TOTAL <br /> REMARKS: � / 1 � � <br /> �� Gi'.'ir � i� (7�ur/ i� .r�'_ _ � <br /> _�—_-_!_.—_—"_ —. _.1- ." _ " _ . _. <br />