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i <br /> ApP�. ''1 /' �7 C:TY OF EVERETT seavice <br /> No, p�,�OC`Q ( ORI7ER I��. . . ,' �.' <br /> APPLICATION FOR WATER SERVICE �-. � � � �1J' <br /> � FIXED DATE-�) /�_tc'� L� <br /> � /y DO � <br /> �'�q( DEPOSIT c /,�, ! / W ��• <br /> �'.1 =__{J.�v No._- <br /> 9 ///+++� I (� "l <br /> SERVICE (BYAOpRE86)_����LJ�J�Yl�I/ !Y BLK.___LOT_�[�ZAD�7..�_U(� <br /> OWN6R-��� �r�,�,s'r.rt _CONTRAGTOR_ _ <br /> ^ FLAT <br /> INSTALL�� RED SERVICE-_ _- _ _. __ _ <br /> I HEREBY APPI.Y fOfi THE USE OF WATER IN ACCOR�ANCE WI7N THE r ` <br /> ORDINANCES AND POLICIES OF THE WATER DEPARiMENY NOW E%ISTING V�� � � ��-- <br /> OR AS SAME MAY BE HEREAF7ER CHANGED, slcr+eo: X �S! � /� <br /> MATERIALS $i1N.� IIN. � 2 R!. i�__ PPICE AMOUNT <br /> PIPE COPPER - GALV.-- STEEL_ �� <br /> CORPORATION <br /> CURB COCK OT I I <br /> SERVICE BOX PLASTIC -- C 1 I <br /> METER VALVE � <br /> -_-__-. - -_-...__.__--- -_-_____- ._ __- _-.- <br /> METER No. TYPE: I K <br /> METER BCX GONCRETE SMALL �LARGE <br /> _-_ -_-I-_ _._ <br /> I <br /> _-.-___ i--i � <br /> - -I�-I_ <br /> _ '-I - <br /> - _ -_I- � I_ - <br /> - _ _ _ -__I- I �ill ' -_ - <br /> �ON <br /> DA7E INSTALLED: �` i � .�/ I J OFF - SUE� TOTAL <br /> .b <br /> GODE i LA�OR AND WUIPMENT RENTAL � HOl1R5 RATE <br /> _ � �� <br /> I -- — --- ---_ ____ _Cf�,�-7x°.�Glok --I —� --- <br /> I i <br /> ' -0-�L-�����--- ---- �-- -- - <br /> � <br /> -� --- - __- - - - <br /> _ � - I _ <br /> -� I _ _ - - <br /> , - --- - _ - __ -- - --- ---- - ----�-- --- - - <br /> 70TAL <br /> REMARKS: <br />