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�� . ._ � _ = N-=�--�� <br /> st"""` No 8044 <br /> ArPL. //�`OQ� CITY OF EVERETT ORD£F <br /> No. L ✓Ou qpp���qTION FOR WATER SERVICnE n <br /> � . , r.rl`�I�G'_���__L-' �Y" I ! ��/ DATE � / / L-1Y� <br /> ,�FIXED ' <br /> .�' W.O. <br /> � tlCMlIT s No.- <br /> (�I3 - 25�� 1Q. l�� BLK.. LOTiE_lLAD �IdLl6�f! <br /> SERVICE ��v..__. � <br /> (��:i� CONTRACTOR ------ <br /> OWNER- <br /> FLAT <br /> INETAL� METERED SERVICE � -�� <br /> I NEREBV APPLY FOR TXE USE OF WATER IN ACCORD�NCE WI�H THE <br /> ORDIN�NCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING s�cneo: X ------------- ---- <br /> OR AS SAME MAY BE HEREAFTER CHANGED. <br /> I �/ IN. 1 IN. i 3 IN. I � PRiCE �MOUNT <br /> MATERULf — I <br /> � � P�P� COPPER•• GALV.•• STEEL __ L�. - <br /> CORPORATION -- �,-- -'� I II � <br /> I -� � I _-�.-J ._ <br /> GURB GOCK �T I <br /> SERVICE BOX PL/�STIC •• C � ' ,i <br /> _.. � _ _ __._- _.__ _-._ �� <br /> METER VALVE __ ---.--- - �rc- ' � <br /> TVPE: fi4}� �, � �---_-� - <br /> METER No. �����___ _.-��"" J/l�_..I�.J._- I 1 � - ; <br /> METER BOX CONCRETE _ SMALL . LARGE I I� I� <br /> —_ I_—_—I_I__ <br /> _ __--__'— I ' —�_I— <br /> �fI �i <br /> —.—.I__I — �— '— <br /> _ - ---; �=�- <br /> __ -i �i--; <br /> ,q ON <br /> � OFF SUB TOTAL <br /> DATE INSTALLF_D�I��b�Gf� � � <br /> �O MOUR6 R�TE <br /> COO[ I LABOR AND EOUIPMEN f RENTAL <br /> �1��� --- - --� - <br /> i - � -_ <br /> NO ACTION _� _ <br /> II ___ __ '—__— __�j�E_�SCO nn cnn�i�g_I <br /> -- applications �aiiLo�it a <br /> � Bac o°,�; ; r�. •• � =.:,ruttatian <br /> i <br /> �_ � TOTAL <br /> �eEMARK3� RS"^^i `i ' d'/ �i/� _- _-- <br />