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SPn�- {a �GrT�i�� 9�(��Q� � <br /> APPL. '�j��.(�, <br /> No. � /�l�/ I CITY OF EVERETT � SERVICE N° 6642 <br /> APPLICATION FOR WATER SERVICE ORDER <br /> � FI%ED E,�i DATE_l��•_19� <br /> � DEPO5IT s ��� `� <br /> �N. O. <br /> �j. No._ <br /> SERVICE (sY ADDNEiB) � � v ��._�� �TI'- ' `�����4�.}��-�,�ly-/� <br /> BIK.__._LOT__��ADD�L`�,/�(�j�/�11 lJ-�L <br /> OWNER �Jr 'D� U p�v - <br /> i� - CONTRACTOR_ <br /> J FLAT __-- _—___---__- ' <br /> INSTAL RED SERVICE��__�� G../��.__� _ j <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WIT THE �(/ I <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMEN7 NOW E%ISTING / .�- <br /> OR AS SAME MAY BE HEREAFTER CHANGED. stcNep: X q�L/_ _ �/n�� � <br /> MATERIAL: Y� IN. 1 IN. I 2 IN. ' <br /> P�PE � I PRICE � AMOUNT <br /> __ COPPER-- GALV.-- STEEL � I <br /> CORPORATION _- -- - — — ----�---I`�-!---- _---{- — <br /> —J <br /> GURB COGK OT --- —� --I—i— I -- <br /> SERVICE BOX PLASTIC __C I _� I I �I � <br /> � —.-_.. _-_ —_--• <br /> METER VAWE -- ---� , <br /> _- . _____ . . . .- <br /> _-. _ . -_- - '_-�I <br /> I . .._ . _ _ _ _ . _ <br /> METER No. - -- -�- � <br /> TYPE .w I <br /> __. ._ _ '__ _.'-_ . <br /> _ __._ -_. __ <br /> i <br /> ME7ER BOX CONCRETE _ _ SMALL LAR E I I ; <br /> __ __._.'__—. <br /> I I � ___-_ --. <br /> —_'—__ -'-___._-_- � . _.'___ __'_ — i <br /> - � , -� -- ---- - � <br /> ---- <br /> _ , i , - <br /> ---- � <br /> -- --- -- <br /> _ -- � - - <br /> _-- , , <br /> ------- <br /> ---- ---- <br /> - <br /> ----- <br /> - --- _ --------�- I <br /> � -- -- ----- <br /> , -- -- <br /> ---- ----- � <br /> ---------I- i --�- --- -- ---- <br /> I � oN / <br /> DATE INSTALLED: OFF � Z .3 �,/ SUB TOTAL <br /> COOE I LABOR ANO EOUIPMENfRENTAL <br /> � HOURS RATE <br /> �-���- ��-- - - ---- � <br /> ; — — -- <br /> --- —- -- i <br /> --- ---- ---- <br /> ;---- — - - --- <br /> -- -------- - - --- _ i <br /> _ - <br /> --- — ---�---- - <br /> � ---- -- -------....-----------�--- <br /> -- ---- - - ----- <br /> i --._ ____ <br /> — � ---- -- — <br /> TOTAL <br /> REMARKS: , ,'- �� <br /> - � !_ A J <br /> -�_. c-c1�C�-�- 7__- ----- -- _ _- - - _ -- - -- ------ <br />