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APPL� �5 '�-� � CITY OF EVERETT <br />No. <br />APPLICATION FOR WATER SERVICE <br />� FIXED <br />cK� <br />� DEPOSIT S ��/ <br />S'ERVICE (bY AOORE86�—/_1—�� � �BLK... <br />�� ���� /�� ij� <br />OWNEFL.�ylcGLli� ,61i'r7'3si0�� c �6G='---CONTRACTOR_ <br />� � <br />INSTALL�_�MIE7ERED SERVICE.—_._._— / <br />I HEREBY APPLY FOF THE I15E OF WATER IN ACCORDANCE WITH THE / <br />OR�INANCES �N� POLICIES OF THE WA7ER DEPARTMENT NOW EXIS7ING ( <br />OR AS SAME MAY BE BEFEAFTER CHANGED. s�cN � X. <br />MATERIALS _ �� � �N� � �H• <br />PIP[ COPPER -- GAI.V. -- STEEL <br />�.— <br />CORPORATION � <br />CURB C09K OT �I <br />SERVICE BOX PLASTIC -- C I I <br />METER �lALVE � <br />M1IETER No. — --_—'—� —� �YPE: --_—� �— � I Si --�— <br />METFR BO% CONCRETE SMALL LARGE I <br />� YIl ON <br />DATE INSTALLEO: /.� 3� Q S � � CFF <br />U � <br />CODE �I LA�Ofl ANO EOUIPMEN f HENIAL <br />—� - <br />-- /' �s D/! <br />PEhtARKS: <br />SERVICE <br />ORDER NO. � . <br />DATE4IC�—�Jr __19J � <br />W. O. <br />N o. <br />1����� <br />�- - --- <br />I l.G_- -_ - _ -._-_ <br />I I PRICE 'I hMOUNT <br />SUB TOTAL <br />HOURS RAT[ <br />— .S Tex_I_l_f_+!e —_ <br />---��,�1�r2_�1 n <br />— - �'�'�—� � -- � � �/ --- <br />� <br />_ _-- ----; - -- <br />T�JTAL <br />� I <br />V: � <br />