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'APPL.� /��QO ARALICATION FOR SERVICE SEftVICE �° E 6 4 <br /> ���«�, CITY OF E ER��'I' WA�TJER DEPT. ORDE ��� s/ v _ , <br /> FIXED 4 � // � DATE� _1�� <br /> � / ._�/!'IG�L(/ •'��� <br /> � DEPOSIT ;_�(C; C�LL�•7�, _ _' NoO. <br /> ��I l <br /> l / / <br /> SERVICE (8Y AOONE95) ���I �..'i JL ?�72C�2.-(.c�+—v BLK.___LOT ADD. <br /> O�VNER _CCNTRACTOR_ _ <br /> (�n,�� �I� � " FLAT <br /> �Ib�b �—METERED SERVICE— <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH �H[ /n/ / /r .! / <br /> ORDINANCES AND POLICIES OF THE WATER OEPARTMENT ':ON' EXISTING { -�r��_���� --c-�-1. �..._.E_.—jt1/ <br /> OR AS SAME NAY BE HEREAFTER CHANGED. sicNeolX7 __�r� _ <br /> MATERIALS �+ IN. 1 IN. � 2�If�, � PqICE ANOUNT <br /> PIPE __ SaPPER- GALV.--STEEL _� —� ,r� .1���� <br /> CORPORATION �I •�II/� <br /> �CURB COCK �% J I II �IIp � <br /> SERVICEBOX "PLASTIC'-- C1 I 1D� <br /> METER VALVE <br /> METER No. TYPE: I >6 <br /> METER BOX CONCRETE SMALL LARGE I <br /> I �/(/� <br /> � � I _I I I �.��/ <br /> � � C � 3�ZZ <br /> I <br /> I I <br /> I I �- - <br /> �'CN <br /> DATE INSTALLED: _� _G �. � OFF SUH TOTAL �� � 7, <br /> CODE � LABOR ANO EOUIPM[NTRENTAL ' HOURS RATE <br /> _ I ��M /A � / i � .� .. <br /> i I I � <br /> _ i ,� ,�,�- _ _ I y_ ;.�;�I �`� � .- <br /> I li � I <br /> - � <br /> '� � — — I Z -� n - ' ; �_. <br /> � — -- --- � I � <br /> — I I TOTAL �I5 `"/ <br /> REI✓ARKS: <br /> --.__ —__—_—. --___ _ � J <br />