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APPL.' `�' �� /,PPLICATION FOR SERVICE SLI:ViGE V° j j � S; <br />No. URDF.R <br />f S�, �� CIT'� OF EVERETT WA.TER bEPT. 1�� J�� ZZ �, �. <br />r-, F�xEO , ;`7 � �ATG.'c��-----�� � <br />%/ �� �72,f'_'rct/-�CC , <br />n DEPOSIT ul^1[1__'Cf�G=y �� ryon .__ ____ <br />/ <br />SERVICE (areD�arin) _j�,��/ F�.___ _��1�!_'c"__�'�- ___.OLK.____LOT.___ADD. .. <br />OWNER .�-__ JT _.. _'-_'_.,-,.__-'____CONTRACTOR_—_' ___ __. <br />��,/ FLAT ' i � <br />INSTALL_L.y- Ml�FEAGD SERVICE-i_.. _' _ _. __._'. ___.. ___-__ ______.-___�.'. <br />I HERE6Y APPLY FOfl THE USE OF WATEN IN ACCOROANCE WI1H TIIE / <br />ORDINANCES AND P(1LICIES OF THE WATEq DEPANTMENi NOW EXISTING ,/ <br />OR AS SAME M�Y BE HEREAFTER CHANGEO. eic��ro: % _ _ _v�-��c � _ . . __ _ . <br />II�TERI�L3 }i IN, � I IN. j q �N. ' I PRICE 4MOUNT <br />PIPE COPPEf7•-GALV.--STEEL �_ �_ � I ��\� I� � <br />—._ -.__---____ _-_. <br />r � i <br />_ __-_'_-_'__"'._ __ ._`__ �_._ <br />CORPORATION__________ _ _. ' _ ____ ____ _ I I I ' <br />CURB COCK OT � I �� <br />_ I ' ��_ ' <br />_' '-_-- __ ' ..__'_ '-. LV1 <br />SERVICE BOX PLASTIC •• C I I I /t " <br />- ___ _ _ _ ___ ___ ___ _ L_l ` <br />METER VAWE I <br />-__ '__-______ _.__ .__ _.____.. . . . __._ — __ --. .- <br />_ MFTER NO.-_ __- _'___ --. ___TVPE: . ._ . I 4S _. � . _ - �. <br />_' _ _ "- _ <br />METER 90X CONGRETE SMALL LAFGE <br />_.. '-"_-___ __ ._ '-- _" ____ '_- <br />-_.-_� -- �i <br />-_ _- —'�! ___ Z -_/ .SL? I ��� <br />- �1- c - _ �, ., �, _i -� �-- JI��; <br />P <br />�- � N.,t_r-i __ <br />�..�-��rr�- -- ---- <br />I I � <br />���AN <br />DATE INS7ALLED: '� � , . ' ,'� I � OFF -' - <br />CUDE � _`) ' ^ '._ LABOq ANU EOUIPMEII! HENTAL <br />I ' I I <br />��� . _. ...._._..____._.__ _ _. _.. <br />REMARK3: <br />� SUB TOTAL <br />-i HOI�RF RMC <br />_ .' <br />�-_ <br />_____...__... . ___. ...._-._ ... _._. _...�.__. <br />TOTAL <br />I <br />