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i <br /> �f � ._ <br />) �MV <br />� �� <br /> ,'� _ <br /> �� � <br /> Q � <br /> �►3�n <br /> H� � <br /> fC c) <br /> oH �1 <br /> AiH � <br /> WH <br /> x � <br /> � � e <br /> OH <br /> ��g ' I Tn Pn�T�Nr,_ c��.��_ - <br /> �` n APPL. ����y CITY OF EVERETT seRvice No 64�IH <br /> zN No• I ORDER <br /> �y APPLICATION POR WATER SERVICE 1� ,r., �— � <br /> H � /��('`� <br /> FIXED DATE_yL.� iB <br /> ��y � DEPO5IT s�! J„__ N O. <br /> ��CiJ � SERVICE ur�oona�n�.��!`-� �������` " - BLK.___LOT ADD_. <br /> �y OWNER — COTiSTA CONTRACTOR�' ��t���L� ��ER _ I <br /> . 1� ' ' � <br /> INSTAL MET ED SEFVICE ���r� `Qf --- i <br /> I HEREBY APPLY FOk TIT�-IIS N ACCORDANCE WITH THE I' ���,r✓� -I�µ ^/ <br /> OHDINANCES AND POLICIES OF THE N'ATER DEPAPTMENT NON' F.%ISiING / -.+.c.lJ <br /> OR AS SAME MAY BE HENEAFTEF CH�NGED. e�Guc�: % - -------------- <br /> I M/�TERIAL9 � IN. 1 �N. � 2 Il�. I I PRICE J AMOUNT <br />��I p�pE COPPER--GALV.--STEEL __J' <br />'� � CORPORATION S'�_ G�C�ION ___ _ _�� _ _� '_ <br /> j� , CURB COCK oT , ��kp� ��p Sl'N�« � � __ <br /> I I ._s - Yv`ii-Sn I 1 OUt e -- — _ . <br />�'I L�' SERVICE BOX P��'DK�PS rJi` ����__ �_ ___ <br /> 1 METER VALVE E�ack4lor� Pr.venUon�T� — -- -- — -- — <br /> METER No. f� �iE� ����`- ��'—�--- <br /> '�� �.�:%: --' - -----I � --- - --- -- - <br /> I �N o� METER BOX CUNCRETE _ SMALL LARGE __ <br /> I _I___— <br /> .. — —'_- _ _'I _ i . <br /> i �_ _____ _i �— _ - <br /> — —_' —_� -�—' _— — <br /> _ I �--' <br /> '�s .�-/ I � OIJ <br /> � SUB TOTAL <br /> Dl�TE INSTALLED: I ('� OFF <br /> �n�- �.. LADOR ANO EO�IPMENIRENTAL I HOURS RATE <br /> —�. C i_( - 12 _ _— ---� <br /> � —i � — <br /> ' i �- -- �I <br /> \I (��! -�- --- -- --- �I - I <br /> -�I _ - --�- - , <br /> � TOTAL <br /> REAIARKS: � �.,] � - <br /> ..��;,t;�� �------- <br />