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APPL. ,� ) ��I .��y BERVICE <br /> No. � CITY OF EVEHETT ORDER C, <br /> APPLICATION FOR W�TER SERVICF _N��-.IJc80� <br /> FI%ED DATE_._ <br /> � DEr061Ts � N O.— _ . _. ____ ._ ._ . ... _ <br /> .,` <br /> �— <br /> BERVICE Ao011[ul I��I� - -I�,�L--J�_--'__ ._BLK. . _. _- _�OT I�.� _.ADD.L.(..(J c-1 l�_.�I�- <br /> OWNER � .. GONTRACTOR � J�'I �/ <br /> `--J��L��___- _-_... _. _ __- _ _ . .�.�U-Y lLJ_-- _ _ <br /> IN6TAL REU SERVICE_ - . _._ __._ _-_ _ _ . . . . . _ <br /> -� - <br /> I HEREBY AVPLY FOR 1Hc u5E Of WATER IN ACCOPDANCE WIT11 THE � / �� i�_{-/ . ,�/ <br /> ORDINANCES AND POLICIES OF THE WATER DEP�RTMF.NT NOW Z%ISTING � <br /> OR AS SAME MAY 6E MENEAl7EN CH�NGF� ncr�Eo: X �`�! /_���- cy. �G'/C//IILL L <br /> MAiERUL• �4 IN. 1 IN. 11M. � P� �MOUNT ' <br /> PIPE COPPER •- GALV.•� STEEL I <br /> —___-._.. _.--___ . ._ . .. _ . <br /> __._ __-- _ _-_ _ ' . .. <br /> -__ — <br /> CORPORA710N I . J _ <br /> _ —_--_ —___. __-_ _ . . . .__ ... <br /> CURB COCK OT I � <br /> —_. __ _ _-- ____. __�-- _ <br /> SERVICE BOX PLA9TIC •• C I I � � <br /> METER VALVE � <br /> METER No. TYPE: I �. _ _ <br /> METER BO% CONGRETE SMALL LARGE <br /> —I __—_ _ _ . _._ — '� <br /> _ _. ' __—I ._ _ _ _—___ _- �. <br /> — —_---_- '_I - _-_ . . . ._. -._ - I <br /> _ _ ' _"__I— - �, . ._ ___ .-.. _._ . I <br /> —'_ '_ _ ____ . ' . I - -I'___ I__ I ' _. ' . . - _.__-_ �'. <br /> ` DATEINSTALLED: � a U �� I �l OFF SUB TOTAL <br /> COD[ I LABOq �ND EOUIPMEN( A[HT�L ' NOUR! R�TE <br /> �i.L�J�4� __ _ i . <br /> � - <br /> - - - _ - --- - - <br /> � <br /> - ---- ---- -- - <br /> ----- - i _ <br /> i � <br /> TOTAL <br /> REMARKS: <br /> I <br />