Laserfiche WebLink
Noo. a�0 J77 CITY OF EVERETT SERVICE <br /> ORDER D _j2„ ,&4(2LT�/_' <br /> APPLICATION FOR WATER SERVICE N'V [0_' _ <br /> E] FIXED fJQ, DATE- - Q✓- ) <br /> DEPOSITS `r W.0. <br /> No. <br /> SERVICE IEv ADDRUB)--(Oldl-CJI (.�j BLK.. LLOT,4— p ADD. f13 a 4{O <br /> OWNE LCA(-iG11 ✓ CONTRACTOR—_AJ(J111J <br /> INSTALL I y uer�--reerTrERVICE <br /> 1 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: X __ ___—___-______ <br /> MATERIALS % IN. 1 IN. I A IN. I PRICE AMOUNT <br /> PIPE COPPER-- GALV. --STEEL <br /> CORPORATION <br /> CURB C JCK OT <br /> SERVICE BOX PLASTIC -- Cl <br /> METER VALVE <br /> METER No. -MV _ TYPE: -- <br /> ME7ER BOX CONCRETE SMALL LARGE <br /> ON <br /> DATE INSTALLED: Ej OFF SUB TOTAL <br /> CODE 7 J' LABOR AND EOU IPMENf RENTAL HOURS RATE <br /> I -- <br /> TOTAL <br /> REMARKS: <br />