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�1 FTER KOURS E+�/ERGENCY SHUT OFFlfURN ON SERVICE <br />O�� L/ -d d, at �c� �•3� hours, I ��%i �% 6� rccei��ed a call from <br />(date) (timc) (Scrvicewrorker doing shut ofdtum on) <br />L.r j%� for emcrgenc}• water service shut off/tum on at ���� .2 k� �'� d�� ^J <br />i Part�• reques:ing san•ice) (service addrcss) <br />After latting the rcsident kno��• thcre �could be a charge of (if applicable): <br />• 575.00 Inside City Limits: Emergency turn on or shut o(f request aRer hours <br />� <br />• 51?�.00 Outside City Limits: Emergency turn on or shut otT request after hours <br />• S2U.00 Shut otf for premises where customers stop � Waste valve should be used <br />• SIS.UO Turn on for restnrt of service <br />• Other _ <br />1 agree �cith thz above starement. <br />Nama: � , - r•i'�: e• <br />(Part}• requesting tum on/shut of� <br />m %�( c(iNr4C.._ �le.u�� <br />Addr.ss: o� �C O� /7/ GG S. c� �- L i✓ ��.,� .J� c�o �� <br />` (Address of requesting party) �+ � S( � r LU� <br />Cin• of Ecerett, l;tilities Division ����K <br />_ 200 Cadar Street <br />E�����a�va 9szoi <br />�_06> z��-ssz► <br />�co ti� <br />......... ...................................................................................... <br />AFTER HOURS EhIERGENCYSHL'T OFF/TURN OiV SERVICE <br />7�� , 1i hours. I_ rec:iced a call from <br />- ��1��� ��imz� ($an•ice�corker doing shut offi'tum on) <br />_for emergenc�� ��ater service shut off/tum on at <br />(Part� rcqu�stinu senica) (sen•icm address) <br />Afrer lettine tht r:sident I��o��• there �could be a charge of (if appiicabla): <br />• 575.00 Lnside City Limits: Emereency turn on or shut off request after hours <br />• 512�.00 Outside City Limits: Emergency turn on or shut o(f request nfter hours <br />• 530.00 Shut off for premiscs �vhere customers stop 3c waste �•nlve sliould be used <br />• 51�.00 Turn on for restart of service <br />• Other <br />; �crc:: ��itli thc abccc statemtnt. <br />�ame: <br />(Parn rcqucsting tum oi�lshut offl <br />.�ddr,�s: <br />(:�ddress of requcsting pam') <br />Cit� ef Fvcrctt, l'tilitics Division <br />3'OQ C�dar Slratt <br />F�crctt\�'.a y8?01 <br />