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- APPL. �/J��� CITY OF EVERE'TT seHvicE No � ] 9 � <br /> No, j qppLICATION FOR WA7ER SERVICE oRoeR ��-1e� <br /> � FIXED � C DATE_ <br /> DEP0817f �Q(/ � �!? ��'�TING. s��(�� W,op' -- <br /> � SERVICE ( ADDI1u .) �aS /� �S � BLK._ LOT_—ADO. <br /> OWNE �� J CONTRACTOR <br /> �j b FLAT �� a ��� <br /> INSTALi��—METERED SERVICE — -- <br /> � 1 HEREBY APPLY FOR TXE USE OF WATER IN ACCORDANCE WITH TNE <br /> ORDINANCES AND POLICIES OF THE WATEH DEPARTMENT NOW E%ISTING <br /> OR AS S�ME MAY BE HEREAFTER CHANGED. ner+e,.. X _ _ _ -_ .____ . <br /> MIITERUL/ Y� IN• 1 �N. � 3 IN. � I PRICE AMOUNT <br /> p�pE COPPER-- GALV. -- STEEL <br /> CORPORATION —�� <br /> CURB COCK OT I I � <br /> SERVICE BOX PLASTIC •• G I I —�— <br /> METER VALVE _..______--.— __._ —_ _ _�v ____ ____ ____ <br /> METER No. � 7YPE � n/ I `S i <br /> 99F1 �–ec�Q-- --- --�---�--� — - – <br /> METER BO% CONCRETE SMALL LARGE � li <br /> ' -__ _.— i__ __—i I-_- ____ <br /> __ __I_�_I— <br /> '—I I I <br /> � ---- ——I —i -- <br /> ._- —�--I— --- <br /> I I I I <br /> � I ON <br /> � I <br /> DATE INSTALLED: /O - 6 _ 93 OFF SUB TOTAL <br /> COOE � LABOR ANDEOUIPMEN'fRENTAL HOURS RATE -� <br /> i –_ — _—I _ <br /> --- --- NQ ACfitBtd--i--- -- <br /> -- ----WiR-6-e—ta en oFc—n;er�r:e� <br /> � — - -----�i�v ieatk�ts-wiF+jerrt-a--' <br /> � B�Ckf!ow Preventio�� Co�-."' <br /> I <br /> � TOTAL <br /> REMARKS: <br />