Laserfiche WebLink
APPL �y LcRVICE <br />No. G/�� y CITY OF [VERETT OF.DER NO. <br />APPUCATIOK FO(i IVATE(i SCRVICF Q <br />�I FIXED OQ DAT�I�//.___19LT`� <br />�� y r7� <br />r� DEPOSIT s�� .- S�. �. w N . <br />W. O <br />_ r <br />o.. ._ _ -..-. _ .._ - _"_— <br />y� /. • - _. _- .. _-. ' <br />9ERVICE IeV n0oP5�o1-r' �1l - . �_BLK. . _ . _LOT/�7 q�ff-f� <br />�J� [�,a � , G,�'y <br />OWNEPIY'VL� � -�7� r7Vi ' CO�RACTOR _ <br />n <br />INSTALL�L�I_.�_ E�DSERVICE . . III / <br />I HEREBY �PPLY FOR THE USE OF WATER IN ACCOR�ANCE WITH TNE ^/ ��/^•./n <br />OHDINANCES AND POLILIES OF THE WATEF DEPARTMENT NOW EXISTING ry/� YIlHl1�� <br />��R FS SAME MAY BE NEPE�FTER CNANGED amnEo: °� ��/ <br />MATERIAL9 I w IN.' t IN. ; T N. I PRICE �MOUNT <br />PIPE COPPER -� GALV. -- STEEL I <br />"___-_ <br />. . . .. . . - . ' -- _ _'___'_'— _ _ _._. . <br />COqpORATIOIV ' <br />CURB COCK .__ OT . . _ _' -_ _ _-_'_I _--'_ -i . _ _ _ _'_ <br />SERVICE BOX _ PLASTIC •• C I I , <br />METER VALVE <br />. . _ __.___ . __- ---'._ __ . __ <br />METER No. TVPE: � , �� � <br />METER BO% CONCRETE SMALL I_AqGE _ � <br />._ _'_- __ . ,.. ___� —I—. <br />. —._..- -_ .___ <br />DATEINSTALLED: L �� <br />1 <br />cooe ' <br />RFMARKS: <br />i. <br />_ , .—I—I_-_ <br />� ON <br />� J� I (� OFF SUB TOTAL <br />LAOOR �NG EOUIPMENfNCNTAL <br />- �''J��� �� <br />nauns I n�r[ <br />S� 3� ( H�° <br />�, �r���� � „ I <br />-�' 4i ! / " <br />TOTAL �� <br />