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No?� ` � �� � SERVICE <br /> ��` -__"�"�'"'� ...^.1TY �JF EVEREiT OROER NO. <br /> .1PPLICAiION FOR \VATER SFR�'ICG �//}' /�/ <br /> DA�C�:,��.!_�J' _ J_- -__l�lL <br /> � FIXED <br /> � DEPOSIT 5 oi]S �i W.O. ( __ - '__._ ___. ___ <br /> l�J <br /> C� �y S' .S���1.2zS /� <br /> SERVICE �BY ADDRE88)J O���'h<< --BLKIJ_��t_�- ADO� ''jf�/j'��/ <br /> /�i � - .\ •<;�Gll�� / _- <br /> OWNER.'�±�F- ._ _CONTRACTOR--_-__ _ � - � - <br /> r - <br /> INSTALL �MLAERED SERVICE------- �� --'---- -- - <br /> I NEREBY APPLY FOR THE USE OF WA7ER IN ACCORDANCE WITH THE ,/ _ ��_s'� � < <br /> OFDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTIHG- � \�; � <br /> OR AS SAME MAY UE NERE�FTER LHANGED. sicrveo: X .�� ---- -__.1_�/=—�--- - - <br /> __.__ <br /> MATERInLS �i INl- '1-1N�{-i�JN:'�""� I _'�--r ., PHIC� �MOUNT <br /> �PIPE���s�"/C � COPPER -- GALV.- STEEL ��� _ __ - <br /> CORPORATION ____ � _ I - <br /> U B COGK OT � - - -- <br /> _ --." I.—I _ <br /> SERVICE BOX LASTI -• C I �_I_ _ -- - - <br /> - �-___' <br /> METER VAWE ----- ---- �-- ----- <br /> _'___'--_. _'-. <br /> -_-_--'__. _ .____.__'_- -- <br /> ME7ER No. TYPE: I `w _ _ ___ -- — <br /> METER BOX CONCRETE SMALL LARGE __I_ _-_ _ <br /> 3� �` � <br /> c�. /7'/.rG 7��—----_ -._-- � I —'�---!I,--- -- —— <br /> I —J--'____ _ ...._._ —_ _ <br /> _. _—_. --I �'�_ .- —__- __ _— <br /> __ -__- --j� �� <br /> I — <br /> '_ _ '___-'___— <br /> —' —_- _---_- _.___- ._-___I____�— .i - ,� <br /> � SUB TOTAL <br /> DATE INSTALLED: � G- J�' I r OFF <br /> CO�E ', LABOfl ANOEGUIPMENfR[NTAL MOURS ��T[ <br /> � __._ -'- <br /> -—�':' -.�- -_�..�1_. _.. _ _ -- <br /> -- .�,��r _ •� ---- - -- <br /> -- �� ���/- �-`��"�— � �� - --_ -- <br /> 3 � <br /> - - <br /> ---- - _ <br /> -----1r-�-,,_ _ _ - - - <br /> y .� c � > - - - - - - <br /> -- - - - — — <br /> _ _— . <br /> . , . ,. .. <br /> --- — --- -- - - <br /> .,�c r,'ri/��-nr— - - -_ - — - — — <br /> TOTAL <br /> REh7ARK5: - `` - -- <br />