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� 4:,�%;,{��idlKi6dl���f7.7�i:��1:Md" �� <br /> ' u �•�4j� oo Not Rv <br /> yry��' � G � p � ❑«o����du <br /> T�1RN'oN SHUTOFF SEWERCONST. � N/A�HG. � ewER9U�p. � <br /> � ONLY � <br /> r �yl / ��' �//� <br /> APPLICATION NO.- a`n �� DATE �19L0 � <br /> �vrE OCD �CCT.NO. SUB.ACCT. Mf CUSt. qEV.CL SiZ / NO.UN�T� <br /> 1 OND l�pt , <br /> � ! D 9 9 / � f> o ao <br /> -, ' <br /> � ~�� ,,�Zu��. �����'ua`'� r <br /> � <br /> DILIING NAME !' <br /> i: <br /> i. <br /> DILLING AODRESS � <br /> CITY, STA7E. ZIP a <br /> a' <br /> SERVICE AODFE55 � � <br /> i <br /> OWNER NqME � � �1�1q..t�-�.�� ' <br /> ; <br /> DUILOER <br /> SIGNE�X �- �/` � ��17�_Q� <br /> REMARKS� � � � �� �� <br /> 5.0.�—� BY � <br /> j7` ''YF . . : 9_ - :rvr.,iv'r�'�r'"""A <br /> f�!��J.---- - — - - - <br /> ,_��_�� <br /> TURN ON ❑ SHUTOFF ❑ �HnNGE METER ❑ OATE �g <br /> REMOVE ET R . FEqDING <br /> INSTALL ER NO.��3 "/�Z (S� �J_.y� L/ READING_�Q d� <br /> � r�.i.`J _ <br /> NEW E ICE Y <br /> �_S"-7d a� - <br /> INSTALLEO � ��F eY - <br /> i.'..i a Y le _ - �f. / <br /> OATE ENTEREO ���— - "' � �(,f <br /> 1 <br /> DESCRIPTION K'aTEq SEWER SEWER <br /> SERV�CE SEqVICE CONSTRUCTION TOTAL <br /> CUFRENT CHARGE <br /> BACKCHARGE <br /> CHEOiT AUJUST <br /> OTMER <br /> REMARKS: ��/ ` — <br /> �' <br /> No. � 3i , <br /> ---- ---- ---- - _.=..__:� <br />