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APP�aft <br />�/ <br />No. <br />APPLICATION FOR SERVICE <br />SERVICE ND 2089 <br />ORDER <br />CITY OF EVERETT WATER OEPT. DATE <br />[glFIXED <br />DEPOSIT ' 0. <br />W.. <br />f SERVICE (BY ADDRESS) / 972j 'Le-, SE, BLK. LOT ADD._ <br />INSTALI- METERED <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE /J J �J <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING C r iQ�'/liC.� <br />OR IN SAME MAY O HEREAFTER CHANGED. SIGNED: X. <br />MATERIALS <br />A IN. <br />1 IN. <br />2 IN. <br />PRICE <br />AMOUNT <br />PIPE <br />COPPER- GALV,-STEEL <br />0� <br />I CORPORATION <br />CURB COCK <br />OT <br />j SERVICE BOX- <br />PLASTIC -- C I <br />I METER VALVE <br />1 METER No. <br />L METER BOX <br />TYPE: /x 7j N <br />WN/ ree I' <br />ONCRET SR CMAL L/IGE <br />� <br />, <br />------ <br />--- <br />— <br />-- <br />r 1' L <br />E7; S AIAAIff <br />L <br />- <br />I <br />� <br />I <br />I <br />I <br />- <br />--I <br />I- <br />DATE INSTALLED: /� ` 7AB <br />v /LA <br />R7 ON <br />'W OFF <br />❑ <br />SUB TOTAL <br />CODE <br />LABOR AND EQUIPMENT RENTAL <br />HOURS <br />RATE <br />17 <br />I <br />I <br />I_ I <br />_ <br />TOTAL <br />-_ <br />REMARKS: f�r <br />e1Q4 r� re /`l/�r Ln <br />_/ l <br />