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t� <br />APPL. <br />No. <br />FIXED CCi <br />DEPOSITS <br />SERVICE (By ADDRESS) __KA( L_ <br />CITY OF EVERETT <br />APPLICATION FOR WATER SERVICE <br />INSTALL`, -METERED SERVICE <br />SLK. <br />SERVICE <br />ORDER NO./ �n Q( ' <br />DATE__-�/o70 199 JE <br />W. O. <br />No. -_._ - --_.— <br />-C Sur,f,al e3 J/v <br />ADD., <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE (� T <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW EXISTING - <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGNED:% �•� <br />MATERIAL[ <br />% IN. <br />1 IN. I E IN. <br />PRICE <br />AMOUNT <br />PIPE <br />CORPORATION <br />COPPER •• GALV. -• STEEL <br />_ <br />CURB COCK OT <br />SERVICE BOX PLASTIC •• C I <br />METER VALVE <br />METER No. --_--- S YPE:-- <br />METER BOX CONCRETE SMALL LARGE <br />DATE INSTALLED: C [ <br />7 <br />ON <br />I OFF <br />SUB TOTAL <br />COO[ <br />LAANOR AND EOUIPMENff RENTAL <br />HOURS <br />RATE <br />Of <br />`T <br />TOTAL <br />REMARKS: <br />