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APPL.p�(p�D3 CITY OF EVERETT SERVICE <br />No. <br />No. ORDER NO. <br />_APPLICATION FOR WATER SERVICE <br />04 ��/FI%[D DATE. --1� <br />�{�' DErOBIT ITT �t,t?n��.�c.� �` _ NO. <br />!� =2 �_ ,p — _ �+� BLK.- L07L.L- —ADo /,d,P�aGE� <br />SERVICE IRV AOOB[SSI e <br />ED SERVICE — <br />I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATE.1 1EPARTMENT NOW EXISTING e SSIGNED: X <br />AS SAME MAY r UFDr AETrR [HANGED. <br />MATERIALS <br />'A 14.1 <br />1 IN. <br />E IN. <br />11 <br />PRICE <br />AMOUNT <br />PIPE <br />CORPORATION <br />COPPER-_GALV. — STEEL <br />CURB COCK OT <br />SERVICE BOX PLASTIC •- C I <br />I <br />- <br />METER VALVE <br />METER No. _ TYPE: <br />METER BOX CONCRETE SM/'.L <br />I H <br />LARGE <br />-- <br />I <br />__ <br />__-- <br />Ej <br />DATE INSTALLED: <br />�J i�%�CJ%-- <br />J f— <br />ON <br />� FF <br />SUB TOTAL <br />COOK <br />LABOR AND EOUIPMENf RENTAL <br />HOURS <br />RATE <br />�.. <br />I <br />� j,��/��' <br />� _— <br />TOTAL <br />REMARKS: <br />