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APPL. <br /> •'l(, CITY OF EVERETT SERVICE <br /> No. <br /> ND. OOCC ll!!''3 p�y. ORDER NO. � <br /> - APPLICATION FOR WATER SERVICE n 7 1 <br /> FIXED DATE. -,�LLII.� J a -1 W <br /> rM DEPOSIT s 60 00 W.O. <br /> — <br /> Sp <br /> SERVICE (BY ADDRESS) a3 4 R jA � J� BLK.- LOT-LLADD. /O-&e/V 191OWNER__VT1C_Agar0l__CA)"/AA_ —CONTRACTOR....�L�A./� <br /> I <br /> INSTALL- METEREES�yERVICR' <br /> HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> OR AS SAME MAY BE HEREAFTER CHANGED SIGNED: <br /> MATERIALS Y1 IN.I 1 IN. I E IN. I PRICE AMOUNT <br /> PIPE - _ COPPER•- GALv.._STEEL <br /> CORPORATION <br /> CURB COCK OT <br /> SERVICE BOX PLASTIC -- C I <br /> METER VALVE <br /> METER No. -77ZI - TYPE: <br /> METER BOX CONCRETE SMALL LARGE _ <br /> c � <br /> )/ ON <br /> DATE INSTALLED: II/'Z.NL I OFF SUB TOTAL <br /> CODE LABOR AND EQUIPMENT RENTAL HOURS RATE <br /> I <br /> --------- — -- <br /> TOTAL <br /> \ REMARKS: ' <br />