2710 10TH ST 2016-01-01 MF Import

A�'�'�. � �/ ,��"' _ APP�ICA;T�.�JN FOR SCRViC° seavicE�° L � �i No. ORDER / `I S I'� CI'�Y OF @V�RETT WATER �EPT'. r �FIXED DATE��$_I_�gr�1_. � _ � DEPOSIT �_/S O._ __ W. O. No.__ 1 1 � -% l . �i /D �; � 1� ' ��_�� . d -- SERVICE �eraooaess�--____.1 �L" ��t� _�Z_��Ai'�<" LK. .LOT__._A�D. •— - , __. - � OWNER—l.�. �—L-�_1�..-- __�____—.__.--__ ___..CONTRACTOR_ SG A1 � ' '��_��)_� ___ �� iK� }_K� INSTALL�__METERED SERVICE_. _ I HEREBY PPPLY FOR TY,E USE OF WATER IM pCCOR�A�:CE WITH THE /�////// OR�INANCES AqD POLICIES OF THE WATE4 DEPARTFIENT FOW E%ISTINC � /' // ///��/ �� OR AS SP.ME MAS� GE HERLAFTEP, CHANGED. si��aeo: k.��(�',�/ i1�GLl7�[�� inc-Cp1.1L5 '"___—._ ' ��_""___G:—_ I��'I �,�^N• I � �N• �I_I ��ICE �I AMOUNT PIPF ______ ___CPPER� GALV.--STEEL _____ '� I'_ _I__I�— .U/1_I� �O�I�� COF,PGF.�TiiJN _ __ _ / I I � Ij L CUF20 CUCIC _OT _ � 1 j � � �� . 1— SERVICE 60X _ PLASTIC -- G ( I_I --_� �I I _. __IdETER VA!.VE._ .. ._—_L_ � i SIC[_�f�/". _ METERNa�/ly> ` ��5'23t�._T7PE� Pj4C��(V _I �=--� - - -__ —_ .�11��1-. IAETER BOX CONCRETE `MP.LL� V�RGE (� �� /[�SO P / i�Z—_ -- C��.�_�_o C .� � � -- —�—�� / 'cS�' —I --�-- ---�� - c�+a n r� j i , iti ,-�a.i -�� — �! i ;i� �". '.';J-� , � � � � i — —�- � �� _ --- -� ��—I--�-- ,I n �N DATE INSTALLED: ��3� —��,J I � OFr SUB TOTAL /�� COOE � _-__— .ABOq ANO EOUIPAIrNT R[NTAL I HOUP_^ RATE ------- — — c , . < --- --- � ' � � _- GYP�� t j- � -, �.-r ;;;; �;j �, --- -- S�K� � I o � I� ----- � L �'�•'�r'I SI 3�1 — - - -- - — �1�1------ —�- — :; ;•, r� ; � , ' �< - 'i c �. .. ..t. � I ', � — _ ___- -- -- � - -- — -------- —: - �--- -;— -- --- � ,. � , . --- - ---- - _ __ _ _ �__ --- - ----- ' � , _' , �� __ i � � D - i v q- - -�1 I � -a' �� '� ___ TOTAL I �I� RGAtARI:S: .. .—__—____ --—_____- _ ____—_.—_ .__--_—_—_-__—_..____'___'—"______.".___. . ___—_ . . _. _—_I f/ ? 1 .._._ _ _._. ..__ .. .__ . ._ ._.. . / . . �% .. �6/' !�� —._.