Laserfiche WebLink
APPL <br />No, LSC ! S <br />FIXED <br />D DEPOSIT s <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />SERVICE (D HADD 3ng L1- Ate `-'E 1 gig <br />OWNER I� �Q•CONTRACTOR r� [d/L� <br />INSTAL ETERED SERVIC _2 <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. <br />SERVICE <br />ORDER <br />1\10.4 <br />45 8 <br />DATE <br />W. O. <br />No._ <br />LOT ADD <br />SIGNED: X <br />MATERIALS <br />4i IN. <br />1 IN. 2 IN. <br />/ <br />PRICE <br />AMOUNT <br />PIPE COPPER -- GALV. -- STEEL <br />CORPORATION <br />CURB COCK OT <br />SERVICE BOX PLASTIC -- C I <br />METER VALVE <br />METER No. Q 1 ? ? TYPE: (e <br />1 <br />. /SPAY `Sk <br />LARGE <br />METER BOX CONCRETE SMALL <br />DATE INSTALLLLEED: �v -.V. g <br />ON <br />I OFF SUB TOTAL <br />CODE LABOR AND EOUIPMEN <br />r RENTAL HOURS <br />cr.p-m - -e, <br />RATE <br />clic&/CV <br />TOTAL <br />REMARKS: <br />