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APPL� p�33.? � CITY OF EVERETT <br />No. <br />APPLICATION FOR WATER SERVICE <br />� FIXED 00 <br />�P l <br />� DEPOSIT � V <br />SERVICE IBYAODNE897 � O Y J�ry �" ' �'V' BLK.__ <br />9WNER _ CONTRACTOR_ <br />��FLAT <br />INSTALL�— ERED SERVICE <br />I HEREBY APPLY FOR THE USE �F WATER IN ACCORDANCE WITH THE <br />ORDINANCES �NC POLIQES OF THE WA7ER DEPARTMENT NOW E%ISTING <br />OR A5 SAME MAY BE NEREAFTER CHANGEO. e��� . <br />MATERIALS �/i IN. 1 �N. I IN. <br />P�PE COPPER •- GA LV. -- STEEL <br />CORPORATION <br />CURB COCK OT I <br />SERVICE BOX PLASTIC -- C I I <br />METER VALVE <br />METER No. TYPE: I ?5 <br />METER BOX CONCRETE SMALL LARGE <br />r^�_�3 I �oN <br />UATEINSTALLED: � OFF <br />COOE I LADOR ANDEOUIPMENfflENTAL <br />— --'. <br />REMARKS. <br />SERVICE � . �� ';'t. <br />ORDER IVO. ._ �� ' ..'� <br />DAT��—( —19 �`Z <br />W. O. <br />PRICE II AMOUNT <br />SUB TOTAL <br />I IIOUPS RATE <br />Sf _J\_X � L_L� <br />�,141/e� i � ,� <br />�_z�// I % '�-- <br />- -i ��� � - ' <br />TOTAL <br />