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i <br />SeN+ (� �(A 9/,6,rd, <br />NOPL, a 3 ° y CITY OF EVERET SERVICE No 7074 <br />APPLICATION FOR WATER SERVICE ORDER <br />n FIXED DATE fY in I <br />DEPOSITS (Ir S�' /J No. <br />SERVICE (BY ADDRESS)- 7 I f 0 ' cz- ej BLK._ LOT ADD. <br />INSTALL_'-'Z ' METERED SERVICE_- <br />! HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER nEPARTMENT NOW EXISTING C <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGNED: X <br />MATERIALS <br />'W IN. <br />I IN. <br />j 2 IN. <br />ii <br />PRICE II AMOUNT <br />1 <br />PIPE ] VL COPPER •• GALV, -• STEEL-/ <br />CORPORATION <br />/ <br />CURB COCK OT <br />SERVICE BOX PLASTIC •• C I <br />METER VALVE <br />METER No. i,LXi �� 5' TYPE: I 4_— <br />METER BOX C) CONCRE MA" LARGE_--- <br />T— <br />sue•-L /60/ <br />I <br />Z�011-- <br />_ <br />%i Go�C%� I <br />— <br />DATE INSTALLED: �-� / 7 , c' <br />ON <br />I OFF <br />SUB TOTAL <br />COD' LABOR AND EOUIPMENr RENTAL <br />HOURS <br />RATE <br />NO ACTION <br />Will ha taken on service <br />applications without a <br />I �acRflow i'revenfiun ons ttatlor>— <br />I <br />_ <br />_ <br />TOTAL <br />R4MARKS: <br />q")N W 03C �Yk 9 W T a mm_E <br />