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�p�, '�j ��'� APPLICATION �OR StkVICE <br />M�' Ci7'Y OF EVERETT WATER �Ei'i'. <br />eeavicEN� �6�U <br />ORDER <br />< <br />IX6D � DATE � � Z —19 �_Z <br />� yy <br />� DEPO/IT ��S__ No� — <br />6[RVIC6 (�v wcnRUO�J O — S � 3T%•� �• � �• BLK. ..10T.. —ADD. � <br />CONTRACTOR �� ����AI-���� <br />OWN6R„�/r r� �r � 5"Di -/7'Z �` S.0 �. <br />I HEREBY APPLY FOR THE USE OF WATER IM ACCOl20ANCE WITN THE � <br />ORDINANCES AND �GLICIES OF THE WATER D[PARTMENT NOW E%ISTING SIGNEO:R � <br />OR AS SAYIE MAY BE HL'REAc?gR CHAHGED. <br />MAT[►.IALI ii IN. � I �M• 3 IN. <br />p�pE COPPER - GALV. -- STEEL <br />I I <br />CORPORATION <br />CURB CGC.K <br />SERVICE @��X <br />METER VAL\�E <br />M[TER No. <br />MCTER BOX <br />OT <br />PLASTIC -- C I <br />CONGRETE <br />DATE INSTALLED: <br />COOE i <br />TYPE: � 3f <br />SMALL LARGE <br />I n ON <br />� OFF <br />LABOR AND EOUIPMEN! RENTAL <br />PRICE II AMOUNT <br />SUB T:'JTAL <br />HOURS I RATE <br />— SOTAL �I \ I <br />REMARKS: / ���JJJ - - . �/. •. --' � -J <br />—____ ��,i �.�[�_ ---- --__'. '_ _—_' � __. _' <br />/ d / <br />