Laserfiche WebLink
I <br />� <br /> � � g�R �E 5 9 5 <br /> APPL. / 7 3 PPI.i:ATION FOR SERVICE o� E N° <br /> "°. CI Y F EVERE'CT W,1TER DEPT. '�(D <br /> �ly"�- DAT " � � �� <br /> O/FIXEDO - tiQ.-til/-rC� W. . �— <br /> /�o. � ✓ <br /> � DEPOSIT f No.--- <br /> l-�K�f/�f� � t ��_BLK. LOti� ♦UD.— <br /> p ✓ <br /> SERVICE cer eoonup_L__��--- - <br /> __CONTRACTOR_,- --- <br /> NER ���� r - � � �,Q,.p�� <br /> ✓/(.� FLAT /�Q� ,G� ��� - ZP-�if.i�-�.�La,!'r'^' '"J.�=-- <br /> Ml�1!!O BERVICEl�`1--"==- <br /> M�J7'11L�---1--l— _____ <br /> I HEREBY APPLY FOR THE USE OF WATER IN �CCOROANCE WI7H THE <br /> .t-f <br /> ORDINANCES �ND POLICIES OF THE W�TER DEPIIR7MENT NOW E%ISTING ��aHco -- � �-- --- <br /> OR AS SAME MAY BE HEREAfTER CHANGED. <br />. �4 �N � �N = N� � PRICE AMOUNT <br /> MATERIAL! ' f <br /> P�pE COPPER •-GALV.--STEEL _ `�_ ' �`�� �� <br /> CORPORATION ___- - � g� <br /> URB COCK) � / I ✓ <br /> � I r <br /> SERVICE BOX PLABTIC�C � _ _ ! <br /> METER VAWE ____ - -- "— <br /> METER No. _-_—.___TYPE: ._ ..___--I-1f -- — — — I— <br /> METER BOX CONCHETE BMALL LARGE _ I _— <br /> _ � � =i �b5 <br /> — _ — _—i - —' <br /> � <br /> -- — � - — <br /> _ __ � — <br /> I �DN . SUB TOTAL ,J� �� <br /> DATE INBTALLED: - � OFF � <br /> _ �.. _ �: <br /> COD! L�SOP AN]E0�11YMENT RENTAL <br /> Houae n�re <br /> � .. v . .. . ..- � <br /> II "_ _--_ _____ I _ " . . II _I_—_. <br /> I�� -—�I � <br /> �Il�'.ty. -______ i _ _II— I , <br /> I �_ <br /> I _J'_ I__ <br /> ___..-_------_ . TOTAL / .. <br /> __-- _ <br /> . II— <br /> � '__"'-'._-__.___ I � J'� <br /> � Il ./L_ '_—____. _ I � <br /> I�ll—[ <br /> - I ----- _ �-S �C <br /> , . '� - - _. <br /> REMARKS: -r.�.,....-. _...__ ..____ --. . <br /> - <br /> __ __ --__ �-'- <br /> - • • .: .. i ::.. . .,'_�::., _f <br /> - __' _-_ <br /> -' ___---_J __ . _ _._i._ <br />