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, I <br /> i <br />�•_ <br /> u�. ���`�.�1 <br />� <br /> ; <br /> t.. <br /> -S <br /> �; � I <br />� <br /> ( � <br /> APPL� �� IS� CITY OF CVERETT seRvice �I <br /> No. ORDER �� C � ^ ^ <br /> APPLICATION FOR WATER SERVICE ;� [ ( <br /> � FIXED DATE�IS_____-____f9�i_ . � <br /> � DEPOSIT s �v � W. O. II <br /> . No.--__-- <br /> SERVICE (o/rw�ooaEes)—._1_S..L�{ - r_iL—L[L.� BLK._—_LOT-/�AD�.�_�1_�,jC�L')=LSlX. �I <br /> OWNER__r��r u O�__�C ��l dJ2�.3��C�_CONTRAC70R SRL7_1� I� <br /> �,/, �' L <br /> INSTALL7� �TEREO SERVICE . _ �'� <br /> I HEREBY APPLY FOR 7NE 115E OF WATER IN ACCORDANCE WI7H THE �� /�+ <br /> OFDINANCES ANO POLICIES OF THE WATER DEP.IFTMENT MOW E%ISTING 7` <br /> OR AS SAl1E MAY BE HEREAFTEq CHANGFD. OI�NeO: :C���F_^Lj, .. U1y '1.y L�_ il <br /> MATERIALS �/i IN.I 1 IN. � N. I PftICE qMOUNT <br /> PIPE GOPPER -- GALV.•- STEEL I 'i <br /> _ ._i—_ I�_�.__ _- _ <br /> CORPORA'1-ION � � I <br /> CURB COCK OT I I I <br /> SERVICE BOX PLAS7IC -- C 1 I � <br /> METER VALVE <br /> METER No. _—_. .--_ TYPE: _-__.___.�`N— _-_- __._ - -- _ __.- <br /> _ . _ . _ __—_ .. . ___.- ___� _.___—.— _ — <br /> METER BOX CONGRETE SMALL LARGE <br /> --- <br /> '--__ ..-_ ____..— _'___ I— —�I_-- _ -_ - - <br /> - I �_—I, _ <br /> � � i <br /> -- -- —I �--I-- — _.. <br /> — I —I--- <br /> -- —I I�— -'- -- --- -- <br /> ON <br /> DATEINSTALLEO: � <br /> / � � � n OFF ��/�J SUB TOTAL <br /> i <br /> COOE I LABOR AND FOUIPMENf RENTAL r1U11R5 RRTE <br /> �� U�7g� U/ _ � <br /> � - -,-- -- <br /> , <br /> � �--- -- - -- <br /> - -- ---_.._ . - - - <br /> � <br /> - --- - -- - -- <br /> ' I <br /> -- _--- --- - - -- . _ ----- --- - <br /> - ----- I <br /> - I -- -- _----- ---- � -- - -- --- <br /> TOTAL <br /> REMARKS: <br />�' <br /> i <br />