11014 19TH AVE SE BASE FILE 2018-01-01 MF Import

_. � NoPL� �O� i � � APPLICATION FOR SERVICE 9ERVICEI�� i.;i;jO ,� c� Cf1fY OF EVERBIT WATER DL�P7. oRoeK � RIXED ��S "� DATE__ —18_'__ EPORIT U/ W O. �.S �.5. --5'icd.�.e' Gq�lc�' S/Y��r%it�� c-G�q�.-,�v tJo. Sc_G---- SERVICE (�vwconee�l._�/ D/� ""/�T��/i/= S � ��'�� 1 ��, S— BLK. L07 AOD. � OWNEFL �,i�G/� �`/-!`_�'._// 1' �/ � �--5��- CONTRACTOR 'S�'/ilc� INSTALL ��' MET[RED 9ERVIGF 1 HERE9Y APPLY FOk 7HE ❑SE OF WA7ER IN ACCORDANCE WITH THE / ORUINANCES AND POLICIES OF THE WATER DEPARiMEHT NOW EXISTING � OR AS SAME MAY OE HEREAFfER CHANGED. eicNep� X G��( : - l-C'l /�S �(� ��j MATCil1AL! � IN. I IN. 2 IN. I I_J�^ PRICE AMOUNT P�PE C�P�R-- GALV.-STEEL / ^ I — ;n ' . �Q/ CORPOpA�'F10N / ' L) cl G n S �J�-_.—_ !� . CURB COCK OT I — — �ERVICE BOX PLASTIC -• C I I _METER VALVE I � � _MFTeR No. lt 1 'Z 2 __ TYPE:1}/dcA/` I ;S � ----- —_-- - — METER BOX CONCRET3F SMALL LARGE ��O I 5 _� _ _ I7I C i�C v F__L=�__'__-__' _L__- -- - �� -�-7� L ---- I 1 � ;� C�� � y,.—xr�� R � d.< < . o- . �. r --I - - 7}� — � — — 1L ! Ii5 5"rG'/« /JoY brIHY I)i�I�.� • .—_—_I _. _— — /r Hr r s o,• o., r e r n v� /� r 7� Q S I � I ��-- -- `� � ��i 1 � r .2 'y�"7 ' �rt r �r � ON DATE IN9 TALLED: // C/ / u-. r. �7� /�i `�" �I /'a f' / [� OFF �,ll�`��I/ SUBTOTAL �/ I COOE I LABOR AN�EqUIPMEN�RENTAL I / MOUPS RATE -- Dc��-{� C� /5 CKSS/L•.l ____ I ! .3� J ✓� p// � I �` �— ,fz.Y i —� '_— �_ — --v 75 ___ I 1. z�--" O U .�/ I� Z=� / 40 _ _' � � ! l�� -- -:�-r�L --- - a --17 - -- .- I�--- . .-CLr yA.�i` I_.�.___ ��1!" _! � Z- , ^ Q , 7-7-.-.—_.-- ., ]._ -- --�/-- � I _ . __—_-__—__i-A ��r� � o — ' s- � �'=----_---- L— - _ � _ _ ------- ` ��`_ !". � � -- -- �� ,/ 7G � � � �% TOTAL REMARKS: � �� , _____ . _._ ._ ./ �,� -__-._-__..- _.__ . _._--__ _._ . .._. _ ___. . __.-- _- ___—_ _ ..-..__ _ __ —_--__ �I '— _ _. � � i a I �