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?oeG� . <br />�a� ���8� APPLICATI6H FpR SERVICE <br />No. <br />CtTY OF EVEItETT W�►TER DEPT. <br />� F:X[D <br />� J <br />�rosir s ZZ `,'� �- <br />•r �4- <br />3[RVIC� (�repDen�� � ' .7/� ' �, � g�Z BLK. LOT. <br />OWNER � __j_Dyr�� _,CONTRAGTOR <br />� %. // �rF <br />INSTALL T.�' i�ETtp[U OEkVIC� <br />I HEREBY APPLY FOR TNE US! OF WATER IN ACCORDANCE WITH THC <br />ORDI�iANCFS AND �OLICIES OF THE WATER 06PARTMENT NOW E%ISTI�iG <br />OR !1S SAYE �IAY BE H[REAFfER CHANGED. eicNeo: <br />NAT[IIIAL/ {� IN, f IN. L <br />P�PE COPP�R'- GALV. - STEEL ��I <br />CORPORATION <br />CURB COCK OT <br />SERVICE �OX PLABTIC - C f <br />MBTER Vf1!_Vfi <br />M[TER NoZC� � 7yp� <br />METER BOX CONCR[TL iE <br />LARGE <br />DATE INSTAILED:, " <br />��- � \' - 7 7 I ❑ OFF <br />GOOE � LABOp AND E4UIPMENI' NENTAL <br />_���i].an l/ ��" <br />� �y�GL <br />I�j� , �----------- ---C�� <br />�'Y / <br />1 <br />_ I <br />� � � <br />REMARKS: � � / i � , � � <br />8lRVICEN� is�� <br />ORDER <br />DAT� Z�Ji-S _iBZz. <br />w. o. <br />PRICE (I AMOUNT <br />SUB TOTAL <br />HO�JRS I liATE <br />z� <br />TOT4L II��� <br />