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No. <br />Gfg <br />�I%ED �7 <br />DEPOSIT S D - 0 Q <br />SERVICE <br />FLAT <br />INSTALL <br />APPLICATION FOR SERVICE SERVICE ND 2028 <br />CITY OF FVERETT WATER DEPT ORDER�s <br />DATE . _IO-71 <br />BLK. LOT�AOD <br />,� /.ram . ,.,..._.,..._.... <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING <br />OR AS NAME MAY BE HEREAFTER CHANGED. SIGNED: X <br />MATERIALS <br />iA IN. <br />1 IN. <br />t IN. <br />PRICE <br />AMCIdNT <br />PIPE <br />COPPER - GALV. -- STEEL <br />.7.0RPORATION <br />CURB COCK <br />SERVICE BOX <br />OT <br />PLASTIC -- C I <br />METER VALVE <br />_METER No. <br />METER SOX <br />TYPE: <br />CONCRETE SMALL LARGE <br />— <br />DATE INSTALLED: ',�.. <br />7.5, <br />ON <br />OFF <br />/ <br />`,.� %SUB TOTAL <br />L[l` �HHOURS <br />CODE <br />_ <br />LABOR ANO EOUIRMEN I RENTAL <br />RATE <br />I I <br />I <br />- <br />- <br />TOTAL <br />I REMARKS: <br />