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APPL. � � �� � APPLICATIpN FOR SERVICE SERVICE �d 4 4 8 <br /> No. ORDE: <br /> �� ��� CITY OF EVEREI'T WATER DEPT. -'�'�Z�.t/ ,�� l� <br /> � FIXED DATc__– - 19 "' � . <br /> � DEP061T g C�CJ.\ W. O• _ <br /> No._ <br /> SERVICE IBV AOr.RE651 '��.��� � � ���� BLI<. - —LO7���D.�'��'�T <br /> // <br /> OWNER_� —__ —_CONTRACTOK ����"�� !_ � _ <br /> � i/ � FLAT <br /> INSTAL� -�� r4�iER�bSERVICE— _��� _ <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE / � � <br /> OROINANCES AND POLICIES OF 'HE WA7ER DEPARTMENT NOW EXISTING / '��� ��r/-t- <br /> OR AS SAME MAY BE HEREAFTER CNANGED. s��r� ' r_ —y_ (` —___ <br /> MATERIAL3 �SIN.I 11N. I21N. I � bAic� AMOUNT <br /> PIPE COPPER a GAW.-- STEEL � I I .7Q ��`� <br /> CORPORATION _ � I � II 311r <br /> CURB COC� � � I I —1 `�� <br /> SERVICE BOX PLASTI� =- G I � I �_ ��G� <br /> METER VALVE _ __ _ I--�._ <br /> METER No. TYPE: I 'R I <br /> METER BOX CONCRETE SMALL LARGE <br /> I__ .._-- — I <br /> ---� I _ / I3� <br /> c^T i <br /> ' ° / � o� l�� . <br /> � <br /> ���— -- �— <br /> � � I � I <br /> ON Q <br /> DATE INSTALLED: � 2 �,_L�� I � ppp --G-��/�� _, SUB TOTAL /O <br /> L <br /> CODE I LABOR AND EQUIPIAENT RENTAL I HOURS RAT[ <br /> I i�. –. _I_L._ l � '�� � � , , <br /> � <br /> I�� I � —' I—G— <br /> i � ��i I � <br /> i __ '--"—__ __I _ — � <br /> '_______--"_- __—'_–_–' _. –___11 I <br /> --�� --- -- - -�-- � <br /> ^ rora� 331[�� <br /> aeMaRKs: � <br /> �( --� --- .._ .---- --- - — - --- ------- ---=.. <br /> —-- <br /> �r ��_� �� __ _ <br />