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AP�./ � I APPLICATION FOR SERVICE ORDfiRE N� Z�09 <br />"°. �( 3'' � CITY OF EVERETT WA'TER DEPT. <br />DATE_ �� �-1 --��, � <br />' �FIXED <br />r � ('J W . O. <br />� � �EFO51T g (�F_.C�'i ��� No. -- <br />,� ��Z 7 '�ti'YN �J— j_�-'U —BLK.�LOT �L7_ilDD71��.�ZL�_i���. <br />SERVICE (BY ADDRE45)_ - <br />' OWNERS�'�-�«� ���'�------- --CUNTkACTOR - ---- <br />FLAT <br />� INSTALL.3 � ..__.__.-_-.---"_--- <br />' �- �. � ��-�� <br />� 1 HEREBY AP FOR THE USE OF WATER IN ACCORDANLE WITH THE <br />� ORDINANGES AND POLICIFS OF THE WaTER DEPARTMENT NOW CXISTING ___ __._.___ <br />OR AS SAME IAAY BE 11E.4EAFTER CHANGED. <br />SIGNED: X . _-- — <br />� MAl'F(:IALS � <br />�ri IN. i N. I 2 IN. � i �� PRICE AMOUNT <br />~-- 1 �— <br />i P�PE _COPPE -GALV.--STEEL ✓ � _I -II <br />� GORPORATION ___ ' � �I I --- - — <br />�--- / ��_ � �I <br />� CURB CCCK OT .— �— I I <br />ERVICE BOX� PLASTIC -• C�_ _ -_ ��- --_ - <br />I METER VALVE _._ _ _ __ _ ,__— �--- -- <br />CTYPc: I �" --- — -'- - ___ ' <br />METER No. — <br />�-_--- --_�...-- _- <br />I METF.R uOX CONCRETE SMALL LARGE ___ __.I I � <br />� ._- i <br />� - ------- i <br />I�-- � �y ON <br />I DATt: INSTALLED: � � � l' � aFF <br />��l n <br />�- LA30R A�JO CQl11PMEN'f RENTO.L <br />CI ppE � <br />�/ <br />- -.. � ._( -_ <br />u <br />SUB TOTAL <br />HOl1R5 { RATE <br />TO :'AL <br />i � � . —. _--__ __ -_ _ - <br />I REMARKS: �.'i�.J -[ -c_'- _--_ -____-_'— ". <br />i'._.- —_ __ ,_.-__ —. <br />