Laserfiche WebLink
SERVICE <br /> �PP4,� � 3 9p� �CITY OF EVERETT ORDER o C ,� � <br /> N�' APPUCATION FOR WATER SEFiV"I�CE ����%y <br /> .,,) �j�} O — �JL/ / DATE__,__E�/ 1 <br /> n y�XE� ��v W. �. <br /> lJ/ �x{ DEPOSIT s No.— <br /> ' � � � � � ��?C � �� /��o// .�. <br /> SERVICE (er/�'c�onuc)— ^ p <br /> /v�� � ___�__k7LK._ LOT_�ADD�^��` � <br /> OWNER_.y- �—�' ��� vU�S�'\ . CONTRACTOR <br /> �FLAT <br /> INSTAL METERED SERVICE -- � � <br /> I HEREBY APPLY FOR TNE USE OF WATER IN ACCORDANCE WITH iHE /\=^% %�� <br /> ORDINANCES AND POLIQES OF 7HE WA7ER DEPARTMENT NOW E%IS71NG ei�r+eo: K- --C —�-- —'— <br /> OR AS SAME MAY BE HEREAFTER CHANGED. � <br /> MATERIALS I <br /> �' IN. 1 IN. � 2 IN. I � PR�GE AMOUNT <br /> P�pE — COPPER- GALV.-STEEL _�_I—� <br /> � <br /> CORPORATION — — <br /> CURB COCK OT _I I _I_ _ <br /> SERVICL BOX PLASTIC •• C I I_ _ -- " <br /> METER VALVE __'___._ -- --_____—._ __ —__— —_- __— <br /> METER No. __ TYPE: ____I_�_,_ __-- ---- --- -- <br /> METER BOX CONCRETE SMALL LARGE _____I_ —__ <br /> I I I <br /> _— ——_I _I— _— <br /> '—j <br /> — I__ _'�_ — <br /> _—_ I — — <br /> I I I I i <br /> I 1-YON <br /> � SUB TOTAL <br /> �ATE INSTALLED: (O��)7�� � OFF <br /> /` <br /> COOE � <br /> L�BOR ANO EQUIPMEN'fRENTAL MOURS RATE <br /> � _ Csi�l�R��o�i — <br /> � I _.. <br /> � --- — -�-- --- <br /> —� — --� — <br /> i ��I`�� - - --I- �� <br /> �I --- - �_ - <br /> � I TOTAL � � <br /> REMARKS: ._ --- <br />