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.---- . <br /> � <br />� <br />� Vj � <br /> APPuf��.3/� CI-Y Uf.EVERETT OR�ER� NO. :�� : ��' � <br />� No. APPLICATION FOR WATEP SERVICE DAT /J� �_�B� <br /> � FIXED DD W � <br /> � OEPO5IT s a3 S � r�� /j� ��/ /��� <br /> SERVICF_ (evwoonEee), ��J � / �"��� BLK..�—�-� � ^""'•J�-�� <br /> I �"_ � <br />� O W N ER_� CONTRACTOR__ <br /> 3 �i ` <br /> INSTALL_,L�-- ETERED SERVICE — —]� <br /> I HERE9Y APPLY FCR THE USE OF 'rVATEfl IN ACCOflDANCE WITH 1'HE / <br /> URDINANCES AND POLIUES OF TNE WATER DEPAtiTMENT NOW EXISTING / _ . <br /> I OR AS SAME iAAY BE HEREAFTER CHANGED. slcrveo: -- <br /> � <br /> � }� �ry, 1 IN. � 2 �N. I I Pp�CE MOUNT <br /> MATERIAL6 I � <br />� PIPE _ COPPER•-GALV.--STEEL 3�� � l_—� <br /> Pl4s �. I <br /> CORPORATION �OO.} ' -- <br /> CURB COCK OT / —� -- — <br /> SERV�CE BOX PLASTIC -- C 1 � � ' � <br /> METER VALVE —- �-- <br /> METER No. f_ __TYPE: I 'S _ _� -- <br /> METER BO% CrJNCRETE SMALL LARGE ___ <br /> !$07 � - L- I <br /> ' I ��- - <br /> 5�0 6 b3 c-a- � � --� <br /> �_"�"� _ � -- <br /> _ — _ � �I— <br /> o� <br /> �I — <br /> /� SUB TOTAL <br /> DATE IN57ALLED: � 2� lJ6 � OFF � <br /> HI OUPS � PATE <br /> COOG I LA9CH AND EpUIPMENT RENTAL <br /> --� S/� .���_�e+� --- - <br /> — _ �CI.�hF. I a �� —_ ' —_ <br /> � — �yj.,..� <br /> I _��—"__— ---'f�s-`�_I �� —_ <br /> C� � �� <br /> --'' ��a I� _ — <br /> —II _ ------ _ � 3 ��� ,� — <br /> �_ I -- � TOTAL <br /> ?fMARKS: _ —-- - —'— <br />