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APPL� �F'J � �/ CITY rJF EVERETT SERVICE ` '� '�" r7 <br /> No. ORbER NO. =� V �� �- <br /> APPLICATION FOR WATER SERVICE /�� r� p/� <br /> � FIXED <br /> DA �.�^z - �f -18(L� <br /> � DEPOSIT �O � No�� <br /> � , �/'� z� � � <br /> SERVIC.E (BY AOOREBB).�L_ 6LK._ LOT ADD. <br /> OWNER�_�•*� �/"� ,/�CX)NTRACTOR <br /> ��� <br /> INSTALI.�-��METERED SERVICE — <br /> I HEREBY APPLY FOR THE USE OF WA7ER IN ACCORDANCE WI7H THE <br /> OFiDINANCES AND POLICIES OF THE WA7ER DEPARiMENT NOW E%ISTING <br /> OR AS SAME MAY ti' HEREAFtER CHANGED. slcr+eo: X _ —�- <br /> MATERIALS �w' IN. 1 IN. � 2 IN. I / PRICE AMOUNT <br /> PIPE r ��I I� _ � <br /> CORPORATION � ___ _ <br /> URB COCK OT _ �_� <br /> RVICE BO ASTIC - I I <br /> METER VALVE <br /> METER No. TYPE: ---� I 5f -- ------ � -- <br /> METER BOX CONCRETE SMALL LARGE <br /> _ % � ,S o� I --- <br /> .3 ``�` �F�� � - <br /> Ls� s FNa� � — 1--i — — <br /> _ � � — <br /> ON �DATE INSTALLED: � /_ I � OFF SUB TOTAL <br /> 1!/ <br /> COOE � LABORAND EqU1PMENTRENTAL HOURS RATE <br /> I -_ �CL'�J�7 <br /> I 11� I _ <br /> � n�� I� -- <br /> /�9 � _ -���I <br /> � ��_�_i <br /> ii - ---�-- <br /> TOTAL <br /> REMARKS: / �f/� —���--����0��� O(l! � <br /> 0 UL D - �� ' / / O L �r� <br />