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� <br /> AeP1"�O f���y � APPLICATION FOR SERVICE SERVICE j'�° 12 3 9 <br /> No. ORDEFY ` <br /> ,�f• �,%, CITY OF EYEREYT WATER DEI,�T. --J , . ', <br /> q FIXED DATE—_..{��19�'�� � <br /> � DEPOSIT S__,.J��/). (-C / W.O. � <br /> � No.� <br /> / r—— <br /> '=�J 1 - �-C�%'- iC.-i �/ . 'J l j`_ ,. /// <br /> 5'eRVICE (uvAo�RE65) `- - ' (— _.BLK..��LOT /�,�D�{,-! �Zt-�� �t (' .'.�'f- <br /> OWNER C/✓t.Y-:1/u:..✓ � %�-e�-t�-.�� � i�i� �� %� r <br /> CONTRACTOR'\ - C.�. , F�. �C. .itJ��e_-.-..-, _ <br /> INSTAL� �j / F�lt`gSERVICE ' ���"%ll.� - /'l y' �'� /�F.��_-� <br /> ..�-..��-� /;.r�..�� <br /> I HEREBY APPLY FOR THE USE OF WATER IN ACCORDANCE WITH THE � �� " <br /> ORDINANCES AND POLICIES OF THE WATPR DEPARTMENT NOW EXISTING � / / � <br /> OP. AS SAME MAY BE HEREAFTER CHANGED. s�GN�o: X � ��� =1�`� � �d�'(�•L��----r---' <br /> MATEFIALS � ?G IN.� 1 IN. I 2 �M. I —PR—ICE {p' qMOUNT <br /> P�F'E COPPER - GALV.--STEEL }}�� —� � // I�r�; <br /> �[� � ) <br /> CORPORATION, ` — � �ji��/ <br /> � <br /> CUR6 COCK � OT _ � I I�_'/�(J� <br /> SERVICE BOX FLASTI -- CI / I II��� <br /> METER VAI.VE - <br /> METER No. _____ TYPE: I ;; _ — - - � <br /> METER �OX GONCRETE SMALL LARGE <br /> �- �- �- - L� I � I j <br /> — ���s:��. � __I I—(— �(i� <br /> — -, —,- -- <br /> I � �I <br /> -I _J� _ <br /> � I <br /> -1-I -�I I <br /> I � ON / <br /> DATE INSTALLED: �j -C� - 7 � � OFF � � /�/' SUB TOTAL /t�'% <br /> C / <br /> CODE I LABOR AI�D EOUIPIAENT qCNTAL ` I NOURS RATE <br /> I� I : <br /> � -- �'� -,- _ %'il /.+� � l: <br /> r <br /> i I I <br /> I� ����---- __�L� j-,�� � ;' I�' - <br /> ' - ------ - �--� �'-`::i II 7 I�., <br /> ' .� - :z�� <br /> , - - ��_ , <-✓I / ISo <br /> ---' -- ----- � '' I <br /> , <br /> -- -- -- __ --- �_ ��� � <br /> ; ------� � <br /> � rorn� �7 �� <br /> REMARKS: <br /> '�� __---_--'-' —..—_'_ _ . —_ <br /> �� <br />