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APPL. ^���� SFNVICE �!_ 7854 <br /> NO. �� CITY OF EVERETT OftDER ° <br /> APPLICATION FOR WATER SERVICE <br /> {'IXED �� DATE��7 _Ie� <br /> � DEPOSITs /OS� TO PC��TIN(�j-I �"�� r� �/ <br /> —�. w. o. <br /> /� No. <br /> \ SERVICE I�v DD11nq-52�/./_.�( O��/avfJ J� BLK._ LOTJ� <br /> 'l � ADD._ <br /> OWNER ��/�/�L � ��Gt"O /C, CONTRACTOR <br /> 3I AT — — <br /> INSTAL � METERED RVIGE_.____ <br /> I HEREBY APPLY FOR T OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES CF 7HE WATER DEPAR7MEYT NOW E%ISTING <br /> OR AS SAME MAY BE HEREAFTER CHANGED. eicneo: _ _ _ _ _ _ _ _ <br /> MMERIALS Y� IN.�� � , , I Pp��E ' AMOUN� <br /> P�PE COPPER-- GALV.-- STEEL -- I � <br /> CORPORATION �i - <br /> GURB COCK OT _ — --- ---I--I I— —� — <br /> SERVICE BOX PLASTIC -• C 1 I �- <br /> METER VAWE I — —' <br /> _-- _.--___—__ ...__ - . __ _—_ --I_—__.I__—.. <br /> ...._— __—'—_ .' _ <br /> METER No. I�J. _. ._ TVPE: /�� � I ... �1 � �- — --�— <br /> / VY'P�llN7` " -�_�\ �----{--"--� --- --- <br /> METER BOX CONCRETE SMALL LARGE <br /> � � -- - <br /> _._. .---__—_._ .._--_—�_ <br /> . __' _ I__ __ — <br /> —_ � I I I I <br /> —i-- —� , — - <br /> -- ---�—�-- — <br /> _ ; , -- — <br /> -- ——%�—!-- -. <br /> i I i� - <br /> ON <br /> �A7E INSTALLED• � J _� �3 ? I �� OFF SUB TOTAL <br /> ( ( -� <br /> COOE I LABOp ANO EpUIPiAENf RENTAL � HOl1R5 RATE <br /> I _ � <br /> I ___I <br /> �- ______--________-- I _' <br /> _— __- ----No��rrorv _� — -- <br /> ----- — � <br /> —VI'ill be taken on se�: ;;. I <br /> _ � Dackfl PP��catiorrs—w�i fi��:: i—-- <br /> ..V......"� � TOTAL <br /> REMARKS: �✓ � /1�. /�--- <br /> o� 'Y <br /> �'r .� � /3��� - <br />