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i <br />APPI.. � 66RVICE <br />Ne, ,1' J,7 � CITY OF EVERETT or+n�a n�" (i �i 4 9 <br />APPLICATION FOR WATER SERVICE ��—�1•0��1 <br />FIXlD DATE-__ J <br />� DE�OSIT s �� No�--__--_.-__ __ _. . <br />� _-- <br />' � J 7 {�.� ��:.l' � � � <br />BERVIC[ ��r�ou�u��_�._ '/^ �-. � �c 1 —BLN..— -_LOT-.._-_ADD. ___.__. .__.__ I <br />Jj___ _ <br />OWNlR��.,L_ 7 �LS_L.��-----CONTRACTOR____ <br />--.__. ._. ___._. __ _ __. . <br />� _I I�� .AT ' /, <br />INSTAL� � METERED BERVICE__.�L -�Z-'7�� ----------��---- ��� � -�-- <br />I HENElY APPLY FOR THE I15E OF M'ATER IN �CCORD�NCE WITH TNE <br />ORDIN�NCES �ND POLICIES OF THE WATEN DEP�RTMENT NOW E%ISTING % <br />OR AS S�ME N�Y BE MERE�iTER CMAhGED. •IaH[o: % . . <br />M�T[III�L� K IN. 1 IM. �! IN. � PYICE ' AMOUNT <br />PIPE COPPER -- GALV. •� STEEL If I � <br />CORPOR�TION _�_ __ ._ _--__.___._.__-__.. ____.— --I—_. __ ` . .� -_ -_ __ <br />--_'___-.—_-_.__ _—__..__ _. __--. __-_. ; . . _. .__ - __- _ <br />CURB COCK OT I I � <br />-.. ___— ___.— _ . _ <br />SERVICE BO% PLA�TIC •• C 1 I � <br />_METER VALVE � _ <br />METER No. TVPE: I `f � ___ _ <br />MCTER BO% CONCRETE SMALL LARGE j ' <br />_ ___- __ _ _ _ . _ _ _ . ._ _ . _ _ - _ <br />- - I -- -� -�- � _ . _ _. _ - - <br />DATE INSTALLED: � - �-�L) <br />COD[ � � LAOC <br />�I�� ""�" /_ . -_. __ <br />� <br />—I ___ <br />� <br />r�' ON <br />n� OFF <br />REMARKSt �T�- � C.4�,L ��✓�i /) .� /� f, e_��_ <br />'T � <br />SUB TOTAL <br />TOTAL �I I <br />