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APPL, /� % �� � `� CITY �F EVERETT ORDERE NO. ' �"� % � <br /> r'o. o� lG <br /> � APPLICA'ION FOR WATER SERVICF. ���— � <br /> DATE— 10 <br /> � FIXED � <br /> �OE�OSIT s � �— No�__—_ --- <br /> sERVICE tw De[n _1�S/..Y7-L47�7`/�('�• � �—BLK(. � /LOTC�Z-ADD.�JL�j/ v1�� ��- <br /> OWNER—.—-- �--�,/ �4�ZID���4-�" —,.�'^(`��� ___._ —__ ____CONTRACTO�L�Q��—.—.--. <br /> IN�TALt. ��—MEyTERED 9FqVICF .__ _ - ._.________ __.— —._. — — <br /> TE <br /> I HEBEBY APPLY FOR THE USE OF N�7ER 'H ACCCMP�NCE WITH TME <br /> i.i�INANCES AND POLICIES Of TtIE W�TER DEPARTMF.HT NOW EXIufING � � - <br /> OR .S SAME M�Y BE HEREAFTER �nANGED. •�anco: X�. . -- -- -- — �—— <br /> _ - MIITFRIAI.� � Y� IN. I IN. I IN. ���,� .I rRICE I�MOUNT � <br /> PIP! __ _ COPPER•-GALV.�� FIEEL _ _____ __ ___,4___ �___ I___ _I__ _ _ <br /> f i <br /> CORPORATION __._' __— —.__._--__--_-- -- '--_.� —.— ' <br /> GURB COGK OT � —-- -- <br /> __..._ __ —1 <br /> SERVICE �OX PLASTIC •- C I I _�__ _ . <br /> .—__ --_ . _ . _ _ <br /> METER VALVE -- � - � � ---�— --- <br /> — ' —_ ._ _.. . _ . . _ <br /> . .._ . __ _. . __ _- __— __ —_ <br /> METER No. TYPE; I � ___ ___ ____ _. . - -. — <br /> —___ <br /> __ —__ I <br /> METER BO% CONCRETE 9MALL LARGE ___I _ _ _ _ ________ __ <br /> . --_— _. _ ..___- � <br /> ____'__—___.—__ ._._._ _ _ ' — I I____ ___— <br /> . -- _._._—_ _'_—_ —i —___ '.__ _ __ _. —" <br /> --_- --_.'__ _ _ ______ _ - - � — <br /> . _' _ __ .. _I_ —I__ _I____I_—_I—_ _— __ . —' _ <br /> ON <br /> DA7E INBTALLEU: � I n OFF SUB TOTAL <br /> (.-2 o X',� <br /> COD[ � L�BOR AND FQUIPMEN( RENTIL _ I NOUR� RATE <br /> � � '✓,'t"r/�f7C'T.rJi�-- _ . - -- <br /> -- -- ---- _--- - -- <br /> � - -- <br /> _ - -.. - -- - <br /> - ___- � <br /> --� -- -- -- _ -- _ -- <br /> ,- - �,� �D'-- - --_-- _ -i - <br /> ---_l� , - -- - <br /> � -- -- - - <br /> --- - - - <br /> _ _ -- -- - --- <br /> _ __ <br /> _----- -_ _ ---- - <br /> ---- -- _ _ -- � <br /> �� TOTAL <br /> REMARK9: . . _. ___ . _ _ - ____.._—_ ---__" <br />