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. <br /> �PP !�c)`:"� •CITY OF E�'ERETT seRvice � • � I <br /> No. LrC?�r-'�� O � OROER NO. . . '. <br /> APPLICATION FOR V�lATER SERVICE /� � •� <br /> � FIXED DA]�,�4y?i���__19�L <br /> Cj <br /> � � DEPOSIT q /�� N O. <br /> K= d <br /> O 7 �) /L� ) / �x/ <br /> SERVICE (9Y ADDNESS)��_/._..T �ZL�—JI� • _-6LK._ ^� LOT.�—AD ._ ' d��— f <br /> OWNER_���_ L—C�x� � __ <br /> CONTRACTOR <br /> / F <br /> INSTALL!-. �METERED SERVICE—__. - <br /> i HEREBY APPLY FOR TNE USF OF WA7ER IN ACCOPDANCE WITH THE � /,� %� � lr�. <br /> ORDINANCES AND POLICIES OF THE WA7ER DEPARTMENT NOW E%ISTING f <br /> OR AS SAM� MAY BE HEREAFTER CHANGED, sicHEo: X; ��" � _ <br /> I.UTEHIALS � bi IN. f IN. � IN. i I PRICE AMOUNT <br /> PIPE __COPPER-- GALV.-- STEEI I _�� <br /> CORPORATION <br /> GURB GOCK OT I I � <br /> SERVICE BOX � PLASTIC -• C I I � I , <br /> METER VP.LVE <br /> METER No. TYPE: I 'e <br /> METER BOX CONCRETE SMALL LARGE <br /> _— _——�___—I_—�_— <br /> I I I <br /> � <br /> _ —I � <br /> I <br /> _—__ _ � � <br /> � ON <br /> DA7E INSTALLED: � . - ' � OFF SUB TOTAL <br /> CODE j LABORAND 4qUIPMENfR[NTAI � HOORS RATE <br /> _�I _—---... -__—� �.__`_ I �' <br /> I I � <br /> -�-- - -9 ��` ' � `�' ' -- - <br /> ; <br /> ��- E--� �-�-- <br /> - -_ _ <br /> -,- , <br /> ; ------- _- _ --- - ----r - <br /> rorn� <br /> t REMARKS: <br />