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. APPC- / �O � SERVICE N� ZZ58 <br /> APP.LICATION fOR SERVICE pRDER <br /> ' "°• 2�`��" CITY OF EVEREiT WATER DEPT. 4• �.� ,074_ <br /> � DATE �"= - - <br /> � FI%ED - �^/� n� <br /> _.____ <br /> 27,.�, °`' No. __ _ --_ <br /> � s ' -4 <br /> OEPOSIT ___ <br /> _ _.._.... L//v/C . ���� ' '- <br /> ' _ ._AD�. ___"_-_— - <br /> I /� �INL) ��-- BLK._'- - .LOT . - <br /> ��n_ «' � � �-- <br /> BERVICE �er�oone�n-- -- - - _.______. . <br /> /- ._ _ -.__-__ <br /> ti _. _CONTPACTOR. ----- - - -- �� <br /> J_ GYJCY`?I�iJ_.. c�-C-�c ..�=r.. - --- <br /> � OWNfiFi•r_/�-t- - -- - <br /> ___'_ . ._ _ _ . <br /> .- . _-__-_--_ <br /> INSTAL � E ERE� 6ERVICE-� � J <br /> __ ___-_. '__'__ - . <br /> I HEREBV APPLY FOR THF USE OF WAiER IN ACCOHDANCE WITH THE .�I�r�„ �1�� __. <br /> � ORDINANCES AND POLIQES OF THE WAiER OEPAHTMENT NUW E%ISTING �i�wEo: xA��l <br /> � OR AS S�ME M�Y BE HEPEAFTER CNANGED. _--- paicE �_ <br /> 1 IN.�I ! IN. � _�.. <br /> M/.TENIAL! I �i - —_ <br /> AMO <br /> ��"�1. __. -. " _ <br /> � PIPE .._ . COPPE�_GALV. •-STEEL__ '_'_.__ ___' �.. . I -- I-- - <br /> _ - <br /> _�. i ___ _ —_il . . ._' _— <br /> � — — <br /> I CORPORATION - 'i . . <br /> ._._.__ __---- ____ <br /> _. . _ - _-. , -- � _ <br /> '_- _- � <br /> � OT ._ ' - _-- � <br /> CURBCOCK _ ___ _ - - - � - _ _ . --. <br /> - _ _- <br /> � FLASTIC � � '�- <br /> ' SERVICE BOX - --- ------ <br /> I _ .._ � I�.- _ __ . - _._. <br /> I METER VALVE - r - <br /> r- -/�... � !-� TVPE: �A µ � I � �� _ - . _ . __ _ <br /> METER No. J ,�,J _ ^_'_'�---�'I � -�I� I <br /> I —_,_ __ . . - -_ .. - _- __ -' <br /> �C METER BO% CONCRETE SMALL LARGE <br /> --- '-�'��' __ � � ' . -_- <br /> � �—� _- _ .__.. _._ .._ — <br /> � _-.! _' __ _ ._ . <br /> I- � —` i 7APFi•v SAno«- — - <br /> 8'�L - �� ' �' <br /> �'-- - — <br /> j _ /I/��r��' SHAA K _ — __ <br /> , � - -- <br /> �- — - ---1-- ' - --- -- --- <br /> _ -�---- -- <br /> _ _ <br /> � _ <br /> — - ' - <br /> -- --- — <br /> I— _ _ -�-- ; -- 'I --i <br /> �_. -- <br /> _ _ I <br /> � SUB TOTAL <br /> �`{ ON <br /> 7%[-�7� � �I OFF - <br /> I DATE INSTALLED: � Houns A�TE <br /> LANOR �ND EOUIPMENf- A�� ��� <br /> crooe I — I _._. - -- <br /> - - <br /> -- - - <br /> - <br /> �--I - - _ _ �O'!1-�' --- --I� - - _ <br /> � i — - _ 2 (p <�����y �' <br /> ------ _- �, , � � �� -- - - -- <br /> i---,- �, <br /> �-- --- - - ��z _ _- -- <br /> .3 �t . - C� <br /> � ------- -- -- <br /> �- _ _i <br /> �_ __ . ____ . -� 70'Ml __ <br /> I—�� <br /> � .. .. ___._. /. <br /> I REMARKS: � _____ . <br /> � �_ �__ <br />