Laserfiche WebLink
,. <br /> NOP�'C,����� � SEFVICl: � ' <br /> CIT`/ OF eVERE'fT owoER NO. <br /> APPLICATION FOR WATEH SEfiVICE �// ��/, <br /> �FIXED DATE���_--_1 S.� <br /> �� DEPOSIT Si�'-j�j- `�' W.O. <br /> -- No._ _____ __ <br /> �{ /, G � <br /> SEr'tVICE (eV ADDRE961�%`'�'/__��'/'-��l_� __gLK�2S LOT��/��ADDC`��� �, <br /> OWNER {' E) Ty_y�„sG—QC—�J��../�_CONTRACTOR__ _ ___ <br /> , � —_ <br /> INSTALL._�_ -TENED S�RVICE _—_ ._____--__—____'_ _ _____ <br /> I HEREBY APPI.Y FOR THE USE OF WATER IN ACCORDANCE WITH THE ��n1 � .� <br /> ORDINANCES ANO POLICIES OF THE WATER OEPARTMENT NOW EXISTING 1 I / L !/ � <br /> CR AS SAME MAY ❑E HEREAPTER CHANGED. eicNeo: Y. `.I�LL�'SjL_�1 f�J G�"SL't ' —_ <br /> _� <br /> MATERIALS I 5i IN.1 IN. � 2 Iq,� I � PHICE A.MOUNT <br /> PIPE ...; �-•F' ' �` COPPEP.-- q <br /> --- GALV.-- STEEL �s' I � <br /> CORP RATIDN � <br /> CUR9 COCK OT I I <br /> SERVICE HOX ��PLJA. ST-IyC •. C I I <br /> METER VAWE �Vl. - � I <br /> _ —_ —__ -' _.._ _ _ .___ _--_ __ _. ._ ___ -- <br /> METER No. �`��_� TYPE: �'" .1tti'���' 6 I <br /> 1 ,�-- ,- - ---y.__--- �-` - � <br /> METER 90X CONCRETE �� '�$MA� _ LARGE _�_� I <br /> -1 ` , .;� -, 3 - - ,�-� -��-- - <br /> ;\ 1 ' �> ll I - - <br /> - --� - -- - <br /> - --- ---� -- <br /> - -- �--� ; i - <br /> �,� ON <br /> DATE INSTAL.LED: L`/�10�`1 -'! �� OFF SUB TOTAL <br /> � l <br /> CDOE 'I -�' L�OOR AND GOUIPMENf pENTAL i1011R5 RATE <br /> - ��R I ,., .R., I _ - <br /> � - -- - .. • -- - --- <br /> ---,- -- - - - - -- - - ---- -��� �� , , -- � <br /> ---- -- --- - -- - --� ' -- -- <br /> 1 , <br /> _-- ---�_�-�S / �3 �.,���(;��!�� --- - - <br /> I —l-- <br /> � <br /> - —I ., <br /> - - -- — <br /> - —I--- — ---- - �_ <br /> - ------ -- - --- <br /> I - -- <br /> TOTAL <br /> aEMnrtKs: ��iUNO• ptFi�ENGE Q'E7u�.�iV �l�E/�utT.�-..t}t<7Z}'L [vlr.-- <br /> T <br />