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r/R"N/: / �/ :j'' _ '�, / / � <br />ApPL, r 7/)��� APPI.ICATJON FOR SERVICE <br />No. I:+V ��TY OF EVERETT WATER DEPT. <br />i �? ?I !.� -� <br />� FIXED <br />�bEP051T s 1� �� �+/ v. J <br />SFRVICE NO 9 S U <br />OFlDER <br />� <br />DATE:.'1�G': �� �i J _ _ 1 <br />1V.0. .' <br />No. -- - <br />S�dRVICE IBY/�PDRcea1J�'=-���v-� �-�` -�� ��'� OLK.___ _'_LOT.'__- 'A <br />OWNER ��� �--�= ._ , _._____. ____ _ _.CONTRACTOR-____—_..___-_ <br />-i/- <br />/. r�e� <br />INSTALL_/ --METERED SERVIGE__- . -� - ---�------- ---- --- <br />_ � <br />I HEflEBY APPLY FOR THE I15E OF WATER IN ACCORDANCE WITH TfIE �� /� <br />ONDINANCES ANC POL�QES OF THE WATER DEPARTMENT NOW E%IS7'NG elcN[�: X.�l L'l_�.'_�-- `�= .� <br />OR AS S�ME MAY BE NEFEAFTER CHANGED. - <br />MATE81AL8 �:'� IN. � 1 IN. I 2 IN. � ' � � I' <br />PIPE �.urrer<�- vn._.. -- ., �.-« <br />—___'_ '=T_.—__ <br />CORPURhTION __ <br />CU.�B GOGK OT______ _____ <br />_3ERVICE BO% _ PLASTIC __C I ___ _ <br />METER VALVE <br />METER No.!/�j �f3 -�Q3i]o'((e/y_7YPE_.��._I_.!f <br />METER BOX CONCRETE _ _ SMAL LARGE <br />_ _ _ �-" —._. <br />ON <br />C4TE IN3TALLED: �-OFF ��� <br />S '�Si'-1 �� .-�"__'_L• <br />CDOE I LABOP AND EOUIPAIlN�RFNTAL <br />- IV�'kiLi�__"_....___ ___"—_—_"_"_'__-_ <br />� - ------ <br />--- `�-�-p�-��->---- ---------- -- <br />--I�..cL�_�.,lLlY=Ss-�`�---._--.�-� ----- <br />___���- P __�__t.� <br />-----�-�- ----- <br />_ ---- <br />t-' - -- - ---- - - <br />--- —l� --� �-- - <br />REMAFKS. <br />._�' ____-_ __- __ . ._. . .. <br />. _.. .___ _ ... . _ _. _ <br />k�� j �� , - . . , � � , <br />� <br />r[� ( <_ . __--"_' <br />�I[¢ 0 AMOUNT <br />SUB TOTAL <br />NOlIR4 � P�TE <br />---I_�— _s. (,. �'� �i �i�f <br />—' ' `; �'i-� 'I �� <br />— _�_ �, I 5�'�17 OG <br />---�- �- }�fc� �,'_.� '� <br />� aL '. S.% !� //1 iDU <br />._ -__._ _. ..____ _-_--_ <br />r <br />_._.—� . <br />