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AFPL. �71�� SERVICE <br /> No. CITY OF EVERETT ORO[R <br /> APPLICAT�ON FOR WATER SERVICE �� 591 � <br /> �[ FIXED DATE_�1'� �$_ <br /> IYI Q� I-�. _-_"_18_ <br /> Y�f / <br /> � D�P051T s (n� W. O. <br /> No.__-___._._._ <br /> SERVICE t/er-��ooa[es��LLL117�L.O�f����___pLK._ LOT-o�.�_ADO._��C50'��a`�'1S <br /> OWNER 10.t'0.��Q�( �tr��L`_CONTRACTOR SQ1Y�P. <br /> $/�n LAT ��_���.�,�T� -__-_--- <br /> INSTAL� RED SERVIGE___.._ <br /> i ' <br /> I HEREBY APPLY FOR THE t15E OF WATER IN ACCORDANCE WITH THE � //' � <br /> ORUINANCES AND POLICIES 9F THE WATER DEPAR7MENT NOW EXIS7ING ! � ��f�� � • // �� <br /> OR AS SAME MAY BE HEREAF7ER CNRNGED. ei�Neo: X .�.(�[1[L�_y._ :_�___p f1.t4q�L ��_. <br /> MATERIALS �' IN. 1 IN. � IN. i PRICE <br /> --- � � � AMOUNT - <br /> P�PE COPPER -- GALV.-• iTEEL � <br /> i <br /> CORPORATION - � �i <br /> _ - i <br /> CURB COGK OT _ I I I` <br /> SERVICE BOX PLASTIC -- C I I <br /> METER VALVE <br /> _-__-_ ._._-.----_ _-._-_.-.- _- __. . <br /> . .. ._. _ ___..- _- ___ <br /> METER No___ TYPE: I �g <br /> -_ -__--.__ __..--.__-__ _-:.__. _-.__ <br /> METER BOX CONCRETE SMALL LARGE <br /> - -. __ I _ <br /> _'___-__-_I-_� -___-_ <br /> I <br /> � � <br /> �- _ 'i <br /> _--"___ _ ___I__ .-- --. - � <br /> ------I _'-_'_I-'-I '- . <br /> 9 �oN <br /> DAiE INSTALLED: //7 IG(: � OFF I SUB TOTAL <br /> � v�J� ��d <br /> GODE I y LRBOq AND EOIIIPMEN f RENTqL HOUftS FATE <br /> --�-�--C�`f��'�-`1/Q�--- � � <br /> -- - ----i--- --- -- i <br /> --�- -- -- - ---- � - ---_- -- - <br /> � - --- -- �- - -- - -- - <br /> � ------ -- -- -- � <br /> - - --- --- - ----- -- ! <br /> _----�-- -- - , <br /> ' _ ---- -- -- - <br /> _ � _ --i----- ---- - I <br /> TOTAL I <br /> Q` REMARKS: <br /> q' --.-_-_-____._ ______._ . _ __. .__ . .. . _ __.. _ . _ . . .. . _. . .__. . _ ___ __ . . __..__- �I� <br />