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� <br /> �,''�.. �CC�� <br /> APPL� ��� � t•=� � APPLECATION KOR SERVIrE <br /> No. � SERVICE NO � ��4 <br /> GITY OP EVERETT WATER pEp7'� ORDER <br /> 'FIXED // (� <br /> � � DATE�-1__ _19_��__ <br /> � DEP09iT 5 �. . <br /> W.O. <br /> Na. <br /> SERVICE (BY ADDRESS) ��� � �� //�� /l_ ��_ J <br /> !�, ._ L—_—BLF(..__LOT � 4 ADD.1� � . I�__ <br /> � , �7 <br /> OWNER��.1,"LVLltL.il_Pilt�'�. <br /> �. . ---.—__.__CONTRACTOR—.? !'� ./..i t�i`�.._ . <br /> INSTALL_�� ` FLAT_ --__ _ <br /> �ME7ERED SERVICE_________ <br /> I I HEREBY APPLY FOR THE 115E OF WATER IN ACCORDANCE WITH THE �,� /+�� � <br /> ' ORDINANCES AND POLICIES OF TkIE WATER DEPARTMENT NOW EXISTING <br /> � ON AS SAME MAy BE NEF.EAFTER CHANGED. si�rveo: X ..,�L�=_�l%� <br /> —1_.__—_ <br /> I A!ATERIALS I ?i IH.� 1 IN. ! 2 IN. <br /> _T�� I PR�CE AMOUNT <br /> � ��PE COppER-- GALV.--STEEL I � I� <br /> I <br /> � CORPORATION <br /> � CURB COCK OT � I i - — <br /> — I <br /> I SERVICE BOX� PLASTIC •- G : I <br /> � METER VALVE — I— --.. <br /> �--' ___-__ _.. <br /> '___—'. ___ '- _- — <br /> METER No. I --- ��— -- -- <br /> TYPE: �5 <br /> —i _ <br /> '— —_—___--�- � <br /> � METER BOX CONCRETE � � —� - -- <br /> _____' SMALL '_ARGE �-- --I�-- � <br /> �- --�---i - ��i- -- ____ <br /> 'L - __I_�_J�- - .-� <br /> I � <br /> I :� ��- _ . .__ <br /> � ---- �-----�,-- -- -- ---- <br /> � DATE INSTALLED: I n AN <br /> i � - � � � � OFF SUB T07AL <br /> {�..�CODE I � LApOR AND EqUIPMENT R[NTAL � <br /> 1 I i HOURS RATE <br /> I -_---"__ I <br /> ' i _"_ .. ______- _'_ . ' <br /> _._-' __. -'____ -.-.-_ __'-. <br /> � ----- ,� ; -�--�- - - - - <br /> � L� i I , <br /> I-I �_h___-_---- __-����---i�-- --- - _ . <br /> II ---------- -- <br /> - --- .. <br /> I--- - <br /> I__ � --- - - - --- ----_._ ---i---- -- -- - - <br /> I <br /> I — TOTAL <br /> REMARKS: ,� _ <br /> I ___`_'_____ ._'—_— <br />