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APPL. ,eM62ao6 APPLICATION FOR SERVICE <br />NO. <br />SERVICE N. 1733 <br />CITY OF EVERETT WATER DEPT. ORDER <br />� ED _ <br />DATE -1 <br />DEP031T s �,�;.- -�- -_1973 <br />'W1.O, <br />1 OSERVICE (BY ADDRUS) OTC <br />BLK.�LOT J AADD.- ER S .r <br />WNER L- inl� <br />I. FLAT .Om CONTRACTOR <br />INSTALL_ SER'JICE__ A W -S.P R.eA.pu_IA,. j <br />1 HEREBY APPLY FOR THE USE OF WATI'R IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY UE HEREAFTER CHANGED. t SIGNED: X <br />� MATENIALB YI IN I IN t IN. <br />I <br />PIPE PgICX AMOUNT COPPER •• GALV. -STEEL <br />CORPORATION <br />I CURB COCK OT <br />SERVICE BOX PLASTIC •• C I <br />METER VALVE _ <br />1 METr ER No. TYPE; -- -- <br />L METER BOX CONCRETE SMALL LARGE <br />DATE INSTALLED; I ON <br />OFF SUB TOTAL <br />coQE <br />LABOR AND EQUIPMENT RENTAL <br />_ I HOURS I RATE <br />I VML <br />REMARKS: ,� ` !" <br />I 1 = <br />