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APPL.I20 " qS5� APPLICATION FOR SERVICE SERVICE N2 I I 1 J <br /> ND. ORDER`- <br /> J- -<' CITY OF EVERETT WATER DEPT. <br /> Ll FIXED DAYS--_______--Ip� <br /> I] DEPOSIT s ����,,N W.0. <br /> —WW_ /0 7/ No.___ --__--___ <br /> SERVICE fav ADDREBBI - r/" • lei K._LOT _ADD. <br /> OWNER ----CONTRACTOR--- <br /> INSTALL-Y7 MVTlE= SERVICE _ <br /> -I HERESY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br /> ASSAM <br /> OR AS SAME MAY BE HEREAFTER CHANGED. ncNED: <br /> MATERIALS %IN. IIN.121N.1 f PRICE. AMOUNT <br /> PIPE COPPER •GALV.-STEEL <br /> CORPORATION <br /> CURB COCK OT <br /> SERVICE BOX PLASTIC C I r <br /> METER VALVE _ I _- <br /> METER No. -TYPE: I H —I{ <br /> METER BOX CONCRETE SMALL LARGE <br /> ON <br /> DATE INSTALLED: 1/�����^�I 0 OFF SUB TOTAL �� 3 <br /> COOK LABOR AND EQUIPMENT RENTAL HOURS RATE <br /> I JJ4-- <br /> - ---- Fa41._.,, 1 a -- - - <br /> TOTAL <br /> REMARKS: <br />