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'I <br /> i <br /> P7 � � I <br /> � y <br /> > Htn I <br /> y <br /> H � � <br /> K O <br /> rl �1 i <br /> htlFih�tl � <br /> VJ H <br /> � x <br /> � � � ; <br /> " �' g I <br /> �V n <br /> '�Y. H p /'I.L-�F I'v�ICi��..,J S�LL /G� <br /> -[�. y� pAjoPL� � <j 3�� CITY OF EVERETT BERVICE �o ] ,� ,� .� <br /> H H APPLICATION FOR 4VATER SERVICE ORDER � <br /> � y F"� '�FIXED DATE�Jd..L�.�Z—f p� <br /> �� � --�., � DEPO8IT � TO POSTIN& �� �q �{ oo. _ �, <br /> Htn (�p� ] �//�� � (' � ou�-kri'L <br /> y �y 9ERVICE 1�r woo11u�1 7iJ I S _ �`�I �-1^=�1.�11�� _BLK.. LOT�ADD._. �� <br /> OWNER J�-- CONTRACTOR <br /> LA ��7 j� — <br /> INSTAL 3 t ERED SERVICE_1_I— % _ _ � <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACC�RDAHCE WITH THE � <br /> ORDINANCES AND POLICIES OF TNE WATER DEPIIR'.MENT NOW E%ISTING '__—�����\-- <br /> OR AS SAME MAY 3E HEflEA.TER CHANGED. elcNeo: X �� <br /> MHTERIALS j( �N. 1 IN. � 3 IN. � � PpICE �MOUNT <br /> PIPE COPPER•-GALV.•-STEEL � <br /> — _ — --�--f--- ��— <br /> CORPORATION _ �— <br /> CURB COCK OT _ I I� � <br /> SERVICE BOX PLASTIC -- C I _I _ I— � - - <br /> METER VALVE {I <br /> '�' METERNO. _ TVPE:_'_____'I_____' �—I�'- '— <br /> ' METER BOX CONCRETE SMALL _LARGE * ____ � � __ <br /> �/ I _i_ �� <br /> '-1 - - -�--�-�- -- <br /> �_� �---I�_._; <br /> . � � , -- -- <br /> _� -- -=;� �-- -- _ - <br /> ,_ , �-,-- - - <br /> �ON I <br /> '�' OATE INSTALLED: � OFF K/� y I SUB TOTAL <br /> ' ' CODE I LA60R AND EOUIPMENf PENTAL I MOUP9 � R�TE _ <br /> _ I I <br /> �_� —� — --� — — <br /> � � _ ��cTior�=— - - --- �-- --- <br /> � ' r:ic¢ I <br /> � �_�� cn s.�, <br /> i � — �`�� �,.:-;1-.r±��T�T � <br /> I —! .�_'��'-'��, ..i,�,afion ---- I — <br /> '�' ;:u_ ..sr" <br /> I _i ��, , , n�..�� i _ TI - — <br /> _ I <br /> TOTAL <br /> REMARKS: �,�,¢�' , ' �_�Lc S <br /> I�i <br />