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ADPL. , APPLICATION FOR SERVICE SERVICE NC) 0 <br /> No .ORDER <br /> 15).5'3-3 CITY OF �EVERETT WATER DEPT. / <br /> DATE ,1--- <br /> --19 7 <br /> FIXED <br /> W.O <br /> Sl ()-0 No. -- <br /> ' DEPOSIT i /J �j -- ' <br /> SERVICE (HY ADDRESS)- C j-O / Y ' `�v' _ BLK. LOT, s l / AD !r'^""�u'16;1tV <br /> OWNER�SCLJ�=-' lN`"! — CONTRACTORL4. ://- -it J, �— <br /> INSTALL METERED SERVICE <br /> I HEREBY APPL FOR THE USE OF WATER IN ACCORDANCE WITH THE ,,, ,,;.: <br /> ` <br /> ORDINANCES At BE HEREAFTER CHANGED.D POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> OR AS SAME MAYSIGNED: X.:--. 7--� r-�"'-4'`C--4-=L ;%-----*;""'i.) <br /> C <br /> MATERIALS 3 IN.! 1 IN. 1 2 IN. PRICE AMOUNT <br /> PIPE <br /> 01 .__....q-ER GALV.-STEEL- 3 1 ' -- _5 /C� l SIV <br /> CORPORATION I 111 -.51D6- <br /> CURB COCK OTII I -I <br /> SERVICE BOX PLASTIC -- C 1 I <br /> METER VALVEI// -- — —'_� <br /> METER No. `/65X1-,)'C'C) .7.3s 7TYPE:_Guta,u 1_ s� r - - .33�3 . <br /> METER BOX CONCRETE SMALL LARGE / I —J <br /> i_—� <br /> ---- <br /> S lea, _:i.� == , '? , . i ! __ — _ <br /> _ .SFr- /a PPL 1 9 ? • -- --- i <br /> ON 6370 <br /> DATE INSTALLED: ) - / 'L.. 6 7 r_4- <br /> OFF SUB TOTAL 1 <br /> CODE <br /> LABOR AND EQUIPMENT RENTAL HOURS RATE <br /> 2 353c�, 7 ° 6 <br /> i / , 1 ^ <br /> .L.tf �,� - -- U <br /> i <br /> _ II i <br /> l IJ. <br /> I I <br /> TOTAL I (Eel IC <br /> REMARKS: _ -- — -- <br /> -- -- <br /> -- -- <br /> t -- -- -- -- <br /> k <br />