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�.4FPL• �OSO � APpLICATIO�i FOR SERVICE SERVICEN�: � � � G <br /> N�� J�� CITY OF 'F.VE�tETT V►'A7'ER DEPT. ORDER /, / / / /_ � <br /> � FI%ED DATE'rY__._• __ __18� <br /> R7� D[POSIT i�:�/'�../'i� W. b. �. ')-,�-'�-�__ <br /> My No.______- <br /> SERVICE,IeYwOORct�)-��� �. J�-'Jl.r ��(Y- �-`�_` '_BLK. .--LOT-_'_ADU._- <br /> , , . <br /> ' / / /, � . -� � l� � f � , i t ) _— <br /> OWNER �11i •�i ' \ i rC' »t(_,_ / d f /G`�NTRACTOIt�/ r ��•' - f��./�>1�� <br /> ^ ,` ' , �__ _-_.�_' -'-.- _-_'�_-i.I:t,.c,.i/: f i !i.r d..�7— <br /> INSTAL'L �" �^-+ IAETERED 7ERVICE__--_.. _ _ __ __—__ ___._. �:r�,� <br /> 1 HEREBY APPLY FOR THE USE nF WATER IN ACCOR�ANCE WITH THE �� < ( <br /> ORDIN6NCE5 AND POLICIES OF TME WATER DEPAPTMENT NOW E%ISTING ' :/t_ l�*�, J <br /> ON AS SAME MAY BE HEflEAFTEN CHANGED. eicH[o: �-_:- ��- __-_ <br /> ..� ,i,j=��t���— <br /> MwTEq1ALs 9i IN. 1 �N. i :: IN. � i�' , PPICC j(���''�AMOUNT <br /> PIPE COPPER--GALV.•-STEEL I i �! I <br /> __._' __—_ _-_ -_-a-__ �._.___ --I—. <br /> CORPORA710N I �� I <br /> CURB COCK OT �-----�------- --� — -- ---I�i �' . <br /> Sif3M7Ct BO% PLASTIC " � -___-__'_ _ ___I_ -�'__ ___lil Z!r(�J <br /> __--__'_'_' __ ____" <br /> J� <br /> METER VAWE _ � _ <br /> -_.-__— _.__ __. ._ ___.. <br /> _ -________-____ '____ '___ - <br /> —-_- <br /> METER No..; r � . ? 1 ; '�' ��J TVPE� ��1 i�� I !f / I�: 3U , <br /> __-.__--�__'_. __-______ _. . ._.-___ .__ ._.___--__-. .-_-___- ____ .__ __. __ ___— - __. <br /> METER BOX CONCRETE 6M1IALL LARGE I <br /> � Y � /. � �I< � t;:�% . _-____.-'--_ . _._ — ___ _�� � <br /> _-_' _' __— ��7 <br /> � � (i _S f V � P. C...r - _I __- � S 8I� O <br /> G • ( l.;�s.'.�a �C � I (�Z` <br /> � ,)(r-�—� - --I - ��I-�-- <br /> ` � -�--- - <br /> �- -- -- — <br /> + �� ' ' ,.� ------ -----i —�-- � fn <br /> v ;� ----------- -- ---�-- �- � �--- -- .r� �,,, <br /> � ON <br /> DATE INSTAILED: ,_� 1 ) - �I[) I � ppp ` SUB 70TAL <br /> COOE I LABCP �ND EpI11PMENi RENi�L __ � HOUq9 qATE <br /> I I <br /> "_i —__—____—_— _"__"' _'__—______I—__ ._�."____I <br /> � ----- --- I -�--�-- <br /> — ----- ---------- ----— _---- --- --- —- <br /> � � � <br /> ---,— ------- ---------- i--- --- - i- <br /> --�------ - - __ _ _ __ _ ----- - -------- - ----� —=— <br /> ---------- - _ _ _ _ _ _ - - - -- i__ _ _..---'r---I-- <br /> � � � <br /> � •� TOTAL � <br /> RFMARKS: <br /> . . . .. _ . . ' _ _-_._ <br /> , _.._ _. _. __ . . _.__ _ _. <br /> � �. .,_�/�C� -__' <br />