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APPL. ao 3�3 CITY OF EVERETT <br />No. <br />APPLICATION FOR WATER SERVICE <br />FIXED <br />DEPOSIT s_ / r <br />SERVICE IBY ADDRESS) d I I <br />LOT <br />SERVICE <br />IRDER NO 5 1 0 7 <br />�/ /J/ DATE 'V v _IY Q L <br />W. O. <br />No.__ _ <br />1( FLAT <br />INSTAL RED SERVI -- -- <br />I HEREBY APPLY FOR THE USE WATER IN ACCORDANCE WITH THE — <br />ORDINANCES AND POLICIES OT THE <br />WATER DEPARTMENT NOW EXISTING <br />OR AS SAME MAY BE HEREAFTER CHANGED. SIGN' - <br />_ PIPE <br />CORPORATION <br />CURB COCK <br />MATERIAL/ <br />_ COPPER -• GALV. •• STEEL <br />OT <br />% IN. <br />1 IN. A IN. <br />I <br />PRICE <br />AMOUNT <br />SER: ICE BOX <br />PLASTIC •• C I <br />METER VALVE <br />_ <br />METER No. TYPEI <br />METER BOX CONCRETE SMALL LARGE <br />ON <br />DATE INSTALLED: I 0 ,i1�Clf I OFF SUB TOTAL <br />CODE %7 AA LABOR AND EOUIPMENI RENTT1ALL�/'�.E�/� HOURS RATE <br />TOTAL <br />REMARKS: <br />