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NOPL. �) �c�•L> i <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />0 FIXED /r ( ., / IG1/5 i& uG ZQ <br />h, AVEs <br />SLK. <br />OWNS S 'fl oC�t'') )3) CONTRACTOR » <br />1 11 ::LAT <br />SERVICE (DY ADDRESS) <br />SERVICE <br />ORDER O <br />N //58 10, <br />__ <br />DATE—18. <br />W. O. <br />No <br />LOT —ADD <br />INSTAL[ • <br />D S VICE <br />I HEREBY APPLY FOR 1 • WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGNED: X <br />MATERIALS <br />IN. <br />1 IN. 12 IN. <br />/ I <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 />—__-- <br />_ J�,' <br />METER No. 2 / 6 TYPE: ?fee/S/410 ai <br />METER BOX CONCRETE SMALL LARGE <br />DATE INSTALLED/Q ... 3/_ ics./ <br />I n<:)N <br />0 OFF SUB TOTAL <br />CODE I LABOR AND EQUIPMENT RENTAL HOURS <br />RATE <br />ti <br />��jU //--�� / ,/� n� <br />(. C [ i24 r 1 ���V 1, �> <br />1, <br />I - <br />I <br />- - <br />TOTA L <br />REMARKS: <br />