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APPL. �'1� (`�2 ' CITY OF EVERE7T r �jj�;[ SERVICE Na 6763 <br /> No. uC %7� {�- ORDGR <br /> APPLICATIO;J FOR WFlTER SERVICE V•' o <br /> onTE—`L'_ _�----ie 9 <br /> � Fixeu G <br /> o w. o. <br /> � :)FPOSITs ) No.__. ______.-.___ <br /> -__ L ' <br /> � SERVICE �or �ooneee�--���`�-/ �N �� ------- -BLK.. LO7_�-ADD.j'..--=���- <br /> 7 � CONTRAGTOR_ <br /> OWNEFi-t��-�-.-�� , ._ -__--.._ ___.-__- <br /> Il�=��.- �� / <br /> - _- _.- _.._ <br /> �,/' � LAT �7 � /�y _ _ <br /> INSTALL�/`-L_-�EREn SERVICE__- �--_/---�NS-J -- -- --� - - - -- r <br /> I HEREBY APPLY FOR 7HE USE OF WA7ER IN ACCORDANCE WITH 7HE ��y�1/�� � � <br /> OPDINANCES AND POLIUES OF 'iHE WATER �EPARTMENT NOW El(ISTING eICHE9���� 1t!['w - � � <br /> OR AS SAME MAY BE HEREAFTf.R CMANGED. - � � �� <br /> MA'fERIALS �/ IN. 1 IN. II 2IN. --I-�I -- -�R�I AMOUNT <br /> p�pE COPPER-- GALV.- STEEL_ _ <br /> . _.___...__—_�-- .-_ ._ <br /> CORPORATION I - — <br /> CURB COCK OT _ __ _ —I I I - -I - - � <br /> SERVICE BOX PLASTIC •• C I _ I I _ _ __- -.--- <br /> ___-- -- -_._ —�I_-.-_ _-_.._ <br /> i <br /> METER VALVE .. _ __-___ -.____- _-__--__ — _. -.I._.__.� ___ ._.-__. ___ _._. .._-.- <br /> -__-.____-._. _ <br /> METER No. TYPE: I `^ ' I_-._ __.___- _ ___.- .__. <br /> ...._._-__-_"__ . <br /> __.—. ---___ _. '.-_-� _ <br /> - _._'______'_- ' <br /> I I <br /> METER BOX CONCRETE SMALL LARGE � ____. __ __-. — <br /> — __._'__' -_.--_"_ <br /> . '_____I _'.--i __.-_ <br /> ___-'--_'-____.-_ <br /> ___�_'____. __'__'__ _ -- <br /> —_ � II __- _"'__ _- <br /> _—i __- <br /> __ �.J__ -_____ __ _- __ <br /> _ I <br /> � <br /> __-- --_" _____ - <br /> '__ - __— � <br /> �I � <br /> ..___.i__'- '�-___'___ _'-__. - -- <br /> .___ -____-_ I— - , <br /> .'_'-__."_ . ._ . . <br /> —__ ---___- � I ', � ', ', <br /> I N 1 �} <br /> DATE INSTALLED: �FF `Z � •� SUB T�JTAL <br /> CODE � <br /> LA60p AND EOUIPMEN�fRENTAI I HOURS RATE <br /> � �3 � a Y I – --._ <br /> 1� _ ---- - - -----___-- <br /> –r—_ __ -- - <br /> --- ---- <br /> i - ---- -- - <br /> --� _ _._ �---- -- -- - - <br /> � <br /> I <br /> - - - - -- - - <br /> _ -- ---- ; <br /> , __ � __ _- - -- <br /> ----- - --------- - <br /> ---- � <br /> I--- --- <br /> ---- -------- -� - - - ----- ---- -- <br /> — TOTAL <br /> REMARKS: ? �['i�2� �?�(l�..�� _ . .. . . __-. __- .__ ..__._ <br /> -----�`– - 'L"Cr�iL. J > '_/ ---- _ <br />