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P <br /> I� <br /> 1 <br /> 0 <br /> �+ <br /> , 30 <br /> KEX <br /> n I <br /> oxo4(Ic�4 <br /> ml� APPL LCITY OF EVERETT r( / ORDERSnNo- 7034 <br /> APPLICATION FOR WATER SERVICE DATEJlz <br /> `• <br /> wCJ �' FIXED L(J_ <br /> o <br /> HEtg <br /> i] n DEPOSIT <br /> SIT <br /> x y SERVICE IBY 'ADDRESS) y BLK..—LOT-,V—ADD. <br /> OWNER--I ' ----CONTRACTOR- <br /> 8 <br /> _CONTRACTOR_ <br /> 8 C[yf . <br /> y LAT <br /> dU1 INSTALL <br /> 1 HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> y(a OR AS SAME MAY BE HEREAFTER CHANGED SIGNED:% _ -- ------ <br /> H O N MATERIALS %IM. I IN.I [ IN. 1 I PRICE AMOUNT <br /> PIPE COPPER••GALV.-•STEEL <br /> CORPORATION —�-� <br /> CURB COCK OT <br /> I. SERVICE BOX -PLASTIC •- C 1 <br /> METER VALVE <br /> c:) METER No. — TYPE: <br /> METER BOX CONCRETE SMALL LARGE <br /> V,, <br /> DATE INSTALLED! / IN SUB TOTAL <br /> OFF <br /> LABOR AND EOUIPMENI RENTAL HOURS RATE <br /> I _ I <br /> -am AM, <br /> I —I-- <br /> TOTAL <br /> REMARKS: L:..�•�l) <br /> r. m m e w �+ m rn 1Y •n Y m m +e .: <br /> I <br />