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AP�'' � 9�� 5 � APP,LlCATION FOR SERVICE <br />No. <br />/q��� CITY OF EVERETT WATER DEPT. <br />�FIXEO — <br />DEPOSIT $ �O�j � <br />SERVICE(9ypDORE55)__�/� �j� ?� \J�L[/ <br />BLK.�OWNER � � <br />CONTRACTOR� e <br />�� FL.4T <br />INSTAL � ME-T£FtED SERVICE_______ <br />i HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE W.4TER DEPAP.TMENT NOW E%ISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. si�Neo: X. `�-�--�� <br />MqTERIALS 3i IN. � 1 IN. I pi{ryL �'—T � <br />PIPE _ OPPE -•GALV.--STEEL ,� <br />CORi'ORATION __-- , <br />CURB COCK OT I <br />SERVICE BOX �L � —� <br />( PLASTIC -. C 1 <br />ME'fER VAWE �-- - ' <br />METER No_____ ____ TYPE: ----_ I �b -- <br />METER DOX _ CONCRETE SMFLL �LARGE I <br />I � ON <br />DATE INSTAL�ED: �- 2�_ 4 7 �� OFF <br />CODE I iABOR ANO Eq111P1A[Nl' CNTAL <br />L. <br />(ZEMARKS: <br />AaN �°v <br />SERVICE �J� � 6 J <br />ORD�{2 <br />, � <br />DATE/ ����U-1�7 <br />W. O. <br />No. �---- <br />yn +c ' .h-LLf -�..��i--.— <br />�-�A�D z��� <br />LC��_ <br />f PRIC[ � .+.MOUNT <br />II <br />SUB T07AL I � O <br />HOURS RATE <br />�^ <br />I <br />i i 3 �s3--_ <br />�— �� �'_3 i � � <br />� <br />� <br />�-- -- li __ � i s o— <br />-- _ �I ,— <br />-��!- <br />TOTAL, I �CI�� <br />