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SERVICE <br /> App /+- © CITY OF EVERETT <br /> ORDER NO.y �J <br /> NO. APPLICATION FOR WATER SERVICE �y�� IYj& <br /> DATEY'—.�-� <br /> FIXED / W.0. <br /> i <br /> Ej DEPOSIT S(O .__ (�,�o �,�l <br /> / fy BLK.- LOT -L— (6d <br /> SERVICE 1■ DDRp/) _ <br /> CONTRACTOR <br /> OWNE <br /> INSTALL. TERED SERVICE <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE BIDNED:X <br /> fOjRDINANCES AND MAY POLICIES HEROF THE <br /> CHWATER ANGED DEPARTMENT NOW EXISTING AMOUNT <br /> AS SAME141N. 1 PRICE <br /> IN. IN. <br /> MAT[RIAL[ <br /> PIPE COPPER --GALV.•-STEEL._ <br /> CORPORATION <br /> CURB COCK OT -- <br /> SERVICE Box BO=_- PLASTIC -• C I - <br /> METER VALVE <br /> ---- TYPE: — <br /> METER No. —_-. <br /> SMALL. LARGE —-- <br /> METER BOX CONCRETE ---I <br /> ON SUB TOTAL — <br /> ClA❑ OFF <br /> DATE INSTALLED: Z– HOURS RATE _ <br /> LABOR ANO EOUIPMENf RENTAL <br /> CODE <br /> it - - ----r/-��a� _-------I — — <br /> TOTAL <br /> REMARKS: --- <br />