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� � <br /> � <br /> X <br /> i . I <br /> APPL' SERVICE <br /> , No. a336o CITY OF EVERETT oaoEa NO. ` � <br /> ^•PPLICATION FOR WATER SERVICE ��} '/ �� ��T+� <br /> �1 FIXED DA7EG�K�__ieQ� <br /> O� <br /> � DEPOSIT s L;O"_^ W. O. <br /> No. <br /> /7 / /7. <br /> SERVICE (BY ADO��REee)..,/�/O (�7 JJ�. �� • _BLK._ LOT_ ADD._. <br /> OWNEF-�[�-"=�r—(�E c/ .cif- .7LG_'__. ___—CONTRAC70R—_..___—. _ <br /> ii —'_.— <br /> INSTALL.�fC._ TERED SERVIGE_________ / I <br /> I HEREBY APPLY FOR TfiE USE OF WATER IN ACCORDANCE WITH THE l <br /> ORDINANCES AND POLICIES OF THE WA7EF! DEPARTMENT NOW E%ISTING � ry <br /> OR AS SAME MAY BE HEFEAFTER CHANGED. 91cr�Eo:-K— ! lS��____ __ <br />� MATERIALE � � IN. 11N. I �I ' _I � PRICE AMOUNI' <br /> P�PE _ COPPER— GALV.•- STEEL �� <br /> CORPORATION <br /> CURCi COCK OT I I � <br /> SERVICE 90X PLA."iTIC -- C I I I <br /> METF_R VALVE --II <br /> METER No. ___ ._ 7YPE: _____I_n5_ I__ __'_— _ ------ <br /> I METER BOX CONCRETE: SMALL LARGE ___i _ I <br /> _ ' _ __I_—I�_I_ <br /> "_ � I �— — <br /> . I—� <br /> -_ I--�---��;-= - <br /> ON <br /> DATE INSTALLED: , I �/(� �L�] :� � OFF SUB TOTAL <br /> `'r- ( � <br /> COOE I LABppANO EQUIPMENfRENTAL I HOURS RATE <br /> I -- S� -T�C- _I_L/��__._ <br /> i __ L, G� � I i ' — <br /> i __ -�z,r� 1 i 1 "- -- — -- <br /> ' `7l-773�n%-- --� <br /> � --- � <br /> _ � ------------- -- I <br /> 7'OTAL <br /> REMARKS: <br /> I_ <br /> � � <br /> , <br /> I � <br />� <br />;�- ' • - <br />