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APPL/�7 tT? � <br />No. / l � l� <br />� �ixeo <br />o,= <br />� �EPOSIT s � y <br />-�.__ ___ ___ <br />APPLICATION FOR SkRVICE SIiRVICE (1�a � f <br />CITY OF EVERETT WATER DEF;, ��DER <br />DA7E__L_L! L•____,_�gE I <br />W. O. <br />NO._____ <br />' _-_'__ <br />BERVICE �nrnnoaese�____ ._.__ _ .. _.._� � ��_� ��3�-._/J�` ALK.___.___LOT.. ��� _ADO_"_��`��� A1� <br />OWNER_ _ --_.__ __ _ . -��'- <br />INSTAL�� .---.-____..______.__.. _ _ -..CONTRAC70R_C{T��,U���� i�, .T�K111�_rlli�, <br />��% {�� M�ED SERVICE-_.___.. ____._ ._ � I��-�(cZ 1�L�i I�t Ll WiJ <br />I HEREBf' APPLY FOR THE USE OF WATER IN ACCOPDANCE Wl:n THE �� � -�----- <br />ORDINANCF.S AND POLICIES Of� 7HE WATER UEPARTMENT NOW EXISTING <br />OR �S SAMF. MAY BE HEREAFTEN CHANGED. <br />rncNco: %____. <br />MATEq11L6 •I � IN.I 1 IN.' S IN. � <br />' P�PE _ OPpE � GALV. •- STEEL <br />-l--�— —._'__. <br />CORPORATION <br />CURB COCK OT <br />BERVICE a0% pLA6TIC •- C 1 <br />METER VALVE <br />METER No.��V(�."_ZY�9�iiQTYPE�;,,�_--� <br />METER BOX CONCRETE MAL LARGE <br />DATE INBTALLFD: I � ON <br />- _ � ' I D -1 % �-OFF ��.e <br />COOE � LAeOq AND EpU1PNFNT RENTAL <br />�- <br />__.._ �.q.� <br />_. __-_.--_._..____-_. <br />� ____- _'_ -_—__"-_'._____ <br />u <br />_����--- - --------� -s�t1.--_ <br />_ � f��t/ �� � � --- -- <br />-- — -- -- --------- <br />, <br />---� ."�----p- i-o <br />� ---- - <br />_-- _ — - _ <br />-_-�---- — _ _ _ _ _ _ _ _ <br />REMARKS: � <br />__'_-'-'1_..�.___.."'_'s.. _.. <br />•�i:F n AMOUNT <br />SUB TOTAL � / �.�;_ <br />/ .i <br />�NOUII! RATE <br />v _;i_�j�--���i i � <br />--I �L__! <br />---'--�— —J � c� � � L I S I <br />_ � � !� 3 I G,� <br />--- —)_ 3-- —_ ,—;; -- � � i s�-, <br />i - 1� _--- <br />_ ___�— - ��-- <br />TOTAL �i ��� 'rjI ill.� <br />a�"!� <br />_ ._ .. _. __ _. . __'_'- _ <br />