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AP.�L. I�� �� APPLICATION FOR SERVICE <br />No. <br />/C; �/�; GT��F� EV[RETT WATER DEPT. <br />FIXED <br />� `7, ( /�� ;ti,: �-'-��✓ <br />i � <br />� DEPOSIT 5 /' � C_�= �. <br />Y'/c- L- � <br />SERVICE (BYAOOPE55�—'� � �� ��_ _pLK._ <br />O�NER_�_ CONTRACTOR_ <br />t !�'Cc : ),: j FLAT <br />M53'ntL. � � ' AT�SD SERVICE <br />I HEREBY APPLY FOR THE USE OF IYATER IN ACCORDANCE WITH THE <br />ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NO14 EX.ISTIIJG R� <br />OR AS SAME MAY BE HEREAFTER CHANGED. SICN[o: _� <br />MATERIALS I�L 1 IN. ±. iu/ <br />I <br />PIPE COPPER � GALV. - STEEL ',�5� I I <br />CORPORATION <br />CURB COCK (OT <br />SERVICE BOX _ ��C� -- C I <br />METER VALVE <br />�7ETER No. TYPE: I_6 <br />METER PDX CONCRETE SMAI_L L/�RGE <br />� ON <br />DATE INS7ALLED: ,' OFF <br />- / I - 7 C% ❑ <br />COOE � LABOR I,NO EOUIPIAEN'f RENTAL <br />�/I:,_�,,, <br />i` <br />.�ir. (' — _... <br />_—� % ( � -� �, __— _'_— .. —'___ <br />, <br />� � . � � - - - --�----- <br />REMARKS: <br />---�-� ?� 'g--c=�'��ts�� <br />, <br />. �' �' <br />� _. _. , �+.,,. . <br />---- _.:�__� _�-L - <br />SERVICE �� 1 Z I � <br />ORDER�, � <br />} <br />�J'�/'- <br />DATE'�'� ��_� `� <br />N/. O. <br />PRICE AMOUNT <br />' 7/ .�ik: � <br />ii 3L3 <br />SUB TOTAL I /��% �� <br />i <br />HOURS pATE � <br />i /�- _.._II�'_I �_. .- <br />� ,� :��1 G �>�� <br />I I� ( <br />�,�- ,'; II �:�-�.;� <br />� � � . -�I' / I � <br />TOTAL II ✓�l� <br />�� <br />� :- ;- a <br />