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APFO <br />No. L �� ✓ <br />FIXED <br />E�KDEPOSIT s (fir -1 clo <br />CITY OF.EVERETT <br />APPLICATION FOR WATER SERVICE <br />SERVICE 1 n r) <br />ORDER NO. .i 0 1.0 1. <br />DATE/��.___19�_ <br />W. O. <br />SERVICE (BY ADDRESBI � 19TH Gar-/r2.• 17 _ Z _ '3' <br />r-- r UC' `�' J BLK.- LOT ADD. <br />OWNERC+4" OB Lr LATrt-V PAY <br />CONTRACTOR <br />1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE �' >Y �L•04 §- C-O/-��M• co <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED, SIGNED: X CHI G-�S <br />r.�cn uLa <br />K IN. <br />I IN. 12 IN. <br />PRICE <br />AMOUNT <br />PIPE <br />COPPER -- GALV. •- STEEL <br />CORPORATION <br />CURB COCK <br />OT <br />SERVICE BOX <br />PLASTIC -• C I <br />METER VALVE <br />_--_-._ <br />METER No. TYPE: I <br />y' <br />---- <br />— <br />METER BOX <br />CONCRETE SMALL LARGE <br />ll <br />EI <br />- <br />DATE INSTALLED: <br />7_ % <br />-crON <br />E] OFF <br />SUB TOTAL <br />CODE I <br />LABOR AND EQUIPMENT RENTAL <br />HOURS <br />RATE <br />TOTAL <br />