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' wPP�fr I�� I �PPLICATfON FOR SERVICE SERVICE NQ 2073 <br />?i/ 3�/ oROER <br />�"�' CITY OF EVERETT WATER DEPT. <br />� � �� -- �S <br />DATE. .- - . 19__ <br />; � FIXED W � <br />EPO81T s � 7 J/ nQ No..__. . _ ..--..- . _ _____ __ <br />� �'D q.(1.- 29—cr <br />� �, p � ��•�„ '� �or 3_ �_noo. __ — <br />� / � 4/ BLK. _ <br />� 8ERVICE IOY AOPRC��1"-' =4----' - �-��-- -- ---"-- -' <br />/� / C_/_F��M ___ . _..— __.—CONTRACTOR______._ __ ----_ . --- .-_ <br />' OWNERJ�i��r -- <br />i YJ.A'�' _ . ._.__—._ <br />�� INSTAL� I� METEREDSERVICE-------�—' �------� —�-----�� . - . .- <br />' I HEREBY APPLY FOR THE USE OF W�TER IN ACCORDANCE W�TH THE �� ^. y—� � <br />UROINANCES AND POLICIES OF THE WATER UEPARTMENT NOW E%ISTING slcnco: ) «'`���"��Q�� - � <br />I OR AS S�ME MAY BE NEREIIFTEH CNAYGED. U <br />ii 111. � 1 IN. ' 2 . � _ � I PR�GE Ir �MO tNT <br />MATERIALB � <br />I P�PE _ COPPER _- GALV_•- STEEL ___ <br />� CORPORATION _ ____.__ - <br />CURB COCK �T _ <br />�- PLASTIC •• C 1 <br />SERVICE BO% ______._____.__.— ---- - <br />I METER VAWE .._ _ � ----- � <br />�--------)r/ -__- _ . - . . _. i � 'f <br />MET�_ E� R No-1 _7-YZ__._.__ TYPE: e��ir.�. I <br />� METER BO% CONCRETE _ SMALL _LARGE � <br />I i' � v• T_ --- <br />I------ - �-- - _ .-� _ -- - <br />��--------1=-_'- - _�-�tcr=t!_L.-- <br />I _ _ - -- --� <br />_ � <br />I--- --- --- —_ _ _ _ - -7 <br />I 7 �-I �N SUB TOTAL II _— <br />' DA7E INSTALIED: /Q-�G �/�-5 I n OFF �. <br />NOUR9 R�TE <br />CODE I L�BOR AND CQU1I`MENf RENTAL <br />S� � <br />3 _E� -- - <br />___ _ _ <br />_ -- - <br />_ - -- <br />y9�_- 3- - -- -- <br />--- � , _ _ .�- 3 0 - 3 - --- <br />- - <br />�c�l y=--- __3�y � --- <br />ti_� � � --- <br />____ <br />/ 3 ___ <br />2 L L '._ - - <br />__ - - - - <br />--- - � ,� <br />- n � ��._ H TOTAL <br />I REMARKS: <br />i_ _ _ <br />�f��i�S�� -- __. <br />