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qppL. ����� �� -APSSIGA'iION FOR SERVICE s�2vice i�'° 'j j G i; <br /> No. � OROER <br /> � CI7Y OF EVERETT WATLR DEPT. �� <br /> � FIXED �SC� DATE���_19—L_ <br /> '` (JG <br /> � L`EPOSIT g��� \N. O. _ __ <br /> No. p <br /> 2C���L/� ST. BLK. S�LOT_17 AGD.� <br /> SERVICE cer aooaEss�_ <br /> OWNER `,�� � Y � • J-�'+'�� n'�ILS}��_��CONT�7ACTOR L�4 E i C_(�'ESJ_��AI_D��f1],� <br /> i� '�k�t* <br /> INSTAL� � METERED SERVICE— -- - / <br /> I HEREBY APPLY' FOR THE USE OF WA7[R IN ACCORDANCE WITH THE �� �� <br /> ORDINANCES AN� I'OLICIES OF THE WA7ER �EPARTMENT NOY! E%ISTING � __ <br /> OR AS SAME MAY BE HEREAFTER CHANGED. sicNeo: X '__ - <br /> PIATERIALu �i IK. 1 IN. I 21N. I ' ', I Pfi10E AMOUNT <br /> --- —L--� � IT , � <br /> PIPG COPPER-- GALV.•- STEEL__ _ _ I_ . <br /> --j h I <br /> CORPORATION I I I I�! _ <br /> _— _—� <br /> CURB COCK O"f I I li I <br /> SERVICE 60X PLASTIC -- C 1 _ _ _I_ � _JI� I_ <br /> METER VALVE ._______ .__ ____ ___M __� III- <br /> METER No. TYPE: I_5 __ .�`� �: '^' ' i — <br /> METER BOX CONCRETE SMALL LAF2GE � I I <br /> -- — —1— , 1 -� I I <br /> -- _J__I & � � _ . ��- <br /> _ i HG -- �i-. <br /> -----�� � � _ -� <br /> -- - ----� � ��--� - - �� <br /> ON <br /> DATE INSTALLED: [;� - G � . �`,� I � OFF SUB TOTAL _ <br /> CO�E I LA60R ANO EqU1V1/ENT RENTAL I HOURS RATE <br /> -_-- __-__ ���_ <br /> �I I <br /> I �� <br /> I �' I <br /> --' _� � - - _= i- --'i, i. <br /> = � - -� -�� i <br /> --�---��--------- ------- ----- -- -- <br /> JII � <br /> TOTAL I <br /> REPAARKS: • <br /> --w i Gc� �M_5 l�v����E'h�,c1� -- - - - <br /> _ _--- — -- � <br />