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4PPL. ��7' yP�� APP�ICATION FOR SERVICE <br />"�' � u � CiTY OF EYERETT WATER DEe'T. <br />/ j,,`7L <br />Q,' FIXED / �-�.. <br />� DEPOSIT g l:''C; <br />/ u ' .f//7// � <br />SERVICE (BYADDR�S) <br />��C�j- � "'^�-�. �LK.%:y-LO <br />f,, �� � /_.L;,� / <br />,., .'�J'[,`--y�� j� CONTRACTOR__ �'�� <br />OWNER � <br />;�=_� J�� . FLAT `� <br />INSTAL� � --��'��D SERVICE--�- ��� <br />O DENANCESeAND POLIC ES OFETHE WATER EPARTMEN7 NOWWe%6TING j�'�!j' <br />SIGNED: X— �--- <br />OR AS SAME M11AY BE HEREAFTER CHANGED. <br />:dAl'ERIAI.S °A RJ. 1 IN. � 2 IN. I I <br />pIPE � COPPERi- GALV. – ST2EL ��� I�I� <br />/ <br />CORPORA710N _. ---� � <br />-CURB COCKI �eT.� - r <br />—..���_- _-� �� I� I <br />SERVICE BOX� [� PLASTICj-- CI __ <br />METER VALVE ---__. I --- -� <br />McTER No. TYPE: `b ___ <br />tdETER �OX CONCRETE SMALL LARGE _ __ <br />n ON r / <br />� <br />�� (,-� I � OFF I <br />DATE INSTALLED: �' .� .- � �� _ �- �- <br />CODE I /_ yLA�OR AND E�UIPMENT RENTAL I <br />,ER�����w� 6 a � <br />OR�EF� _ <br />�_ � � � i <br />. ��C� '� ' <br />oA�—_-----' 9"=— <br />NJ. O. <br />i_ _— - __ <br />PRICF. � AMOUNT <br />F`ti� �I� .[�)�� 1.� <br />�^ <br />SUB TOTAL �)� " � <br />HOUHS RATE <br />� .' i . �: � ' _" <br />I <br />� � � c'I�I .' �I__ <br />__.—I _"'ll�l II <br />_� � —' TOTAL '�� '%J � %�"/ <br />�. � .. 1 �, ' �Z � Li �� — -.. <br />REA1ARK5: �� i , ... �, . .� r F'_.. � � � U `j. a 1 ��_ ti _j_ .' -- , ' <br />__ __-_ <br />_ _-' `_-__ _ <br />___- _ � � � t. ', I- � :r . r` � � _ . ._^-�___._. <br />• • - ' <br />_-� _ _ ' <br />�� . , i i•._� � ;• . . i ,: . . . . ____ ._ • -. - <br />.��. t! 1 . '. _ _ . . . _ .. __._ <br />