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- �_ _ ,_ . <br />. <br /> , <br /> °'PP�-• APPLICATION FOk SERVICE SERVICE{�° 2 1 1 <br /> No. <br /> i , ❑ XED ��I� CITY OF EVERETT WATER DEPT. DAT�G�� �-'�� <br /> � � � DEPOSIY u ���� � G'¢' �7. � U`-- �� <br />� _ i <br /> . -'� ) No.---_---._ <br />' 9��3/ - � � /3 <br />� � SERVICE �eraoorsess� � '_(3LK._ LC <br /> j , . � � � DD._ <br /> �/r�,. - <br />� OWNER CONTRACT�"�r»� � <br />�. ,/ --_ <br />� INSTAL� 3 T ii �+ ��� � .�i�Ti7___- <br /> � METERED SEItVICE__._. _,[��.}�� � �� �_- <br /> I HEREBY qppLy FOR THE USE OF MATER IN ACCORDANCE WITH THE <br />' ORDINANCES AND POLICIES OF THE WA;ER DEPARTMENT NOW EXISTING '^,i i�J� yn <br /> OR AS SAME MAY BE HEREAFTER CHAI;GED. sIGNEo: X����__«_':w./-�_��7_C}b-y�� � <br /> r A:AT[fliAlu �.i IN. 1 IN. ' 2 IN. <br /> � I PRICE ,qMOUNT <br /> p�PE /COPPER GALV.••STEEL " � <br /> \ �' ` <br /> �--�_-__I_-_-I - T- ' S� � <br /> CORPOI 'T!JN � I - r ��� <br /> I <br /> CURB COCK 07 _ _ i � - - � <br /> 1 <br /> SERVICE BOX_ �LA571C -- C I I I I � <br /> - �_-- � <br /> I METER VAWE � I I -- � <br />� - �1-- <br /> METER No.�Q�� -�u .� f�G�YPE: I >5 � / -{I <br /> �f_�p`L _.-_J--.I___ .__-_ I �� <br /> ME'YER BOX �CONCRETE-y SMALL� L_�_qF(�,� / ��I,, -_I- �� <br /> i "_� �"_ (�' �° /�il- Cm.Gr:. � I I �- � <br /> , �--� �—�� I�f(o_ <br />, „ .`� � � � _. <br />, -�-,;- `o -�-� - - � i ��o <br /> - __- �i- ---{- �L-�- <br /> -=1=:i-- -I- <br />' -- i i � ,- � <br /> I � ON <br /> DATE INSTALLED:S 7 ( , I �pFF ,�/� SUB TOTAL � �� � <br /> e _ <br /> i� 1 . � <br /> CODF. I IABOR AND ECUIPMENTRENTAL � HUUR9 RATE <br /> I r <br /> � ,2:r� r:t_— _ I_ � �. `� i��•I�- <br /> I I <br /> ' — ' I <br /> ---- -------_ <br /> -_�z_�,,.0 II i <br /> ----- -- -�--�---- �. �_,--"--=;�- <br /> i . --- - � <br /> __. � ; , <br /> --�- - -----� --_- ------;-- -- <br /> --��-��---- -`�-�� , ,.. `_ --- i--- --ii----- <br /> ; <br /> -�'`-- ='------' � �' ' ' < <br /> - � _ � -� i�'I - <br /> --- TOTAL I (� I�� <br /> t2=NARKS: <br /> - _��_.L-��-=_' r, _I ,,, i`, __ --- --------------- r' <br /> - ------_ _ ` <br /> _ _ __ - <br /> - - - --- ..__ � . <br />