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�� <br /> � <br /> , <br /> nAio�� �_�CCL���' -�I CiTY OF EVERETT o�oE�Re <br /> APPLICATION FOR WATER SERVICE ��� � � 3 ��� <br /> �UCED � DA7E_____�_�_�19=L� <br /> � DEPOSIT S / "f-'' W, O, <br /> No. __ <br /> //n�/1 �/� �/1-�� C.%- � /nI <br /> � SERVICE (BY AP�RE86�%(!���_1�_BLK._—_LOL � � ADD..�1dL <br /> / /�, �J i ��J{����' �� <br /> OWNEF:---�%�� -I-ac1-<� ��__—.__CONTRACTOR _____._ _ <br /> 3 L ���LAT <br /> INSTAL c ED SERVIGE____._ _.1__ _ _ <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> ORDINAKCES AND POLICIES OF THE WATER DEPAFTMENT NOW E%IS71NG <br /> 9R AS SAME MAY BE HEREAFTER CHANGED. s�cr�eo: X _ . __ __ _ . .__.___.__ _____,___ <br /> MATERIALS I �/ IN.I � IN. I21N. . I ppl�E I AMOUNT <br /> PIPE COPPER-- GALl�_-- SiEEL _ I i — I <br /> � -a <br /> GORPORATION ._ _____ � I—� I _- <br /> CURB COCK OT ___ _I I __� <br /> SERVICE BOX� PLASTIC -- C I I <br /> METER VALVE <br /> METER No. TYPE: �_�—�._I �5 — --_ -- - _ __- - —__ ____ <br /> —_ __ — —_ _._i_.___ __-- _ - <br /> METER BOX CONCRETE SMALL LARGE <br /> —._____— — — <br /> I--L�I— - <br /> _-- _.__...'_— —i— , — — - _ <br /> � � <br /> � � <br /> I --i_J <br /> _ __ -_ ....._— —__—_ .__ —._— ____ <br /> - -- -- I-1 I I--i---- - <br /> �ON <br /> DA7EINSTALLED: � OFF SUB TOT>L <br /> CODE i L4�OR qND EOUIPMENfRENTnL MOUFS NAT[ <br /> �I��c �-' '�---- ----- L�-:r>,���c T�;� -- — --- <br /> � - <br /> ; i —— --- - <br /> — -- -- — �-- --- <br /> --� --- -- —I-- -- — i <br /> I _ —I— -- — � <br /> --..- -- -- -- <br /> _ _— - -- -- -. —.--- <br /> � , - -- <br /> I TOTAL I� I <br /> REMARK �: <br /> —._ ._ I <br /> � <br /> � <br />