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..-.. <br />�..! ��,�. <br />APPL. I <br />rvo. � I�'a 5 �iTY UF EVERFTT SERVICE <br />HPPLICATION FOR WAIER SERVICE oRnER NO. � �� <br />� FIXED DATE_ �✓S____ �8�� <br />D� <br />,�SEPOSIT 5 �� <br />�Q� H�. u. <br />No. ____ <br />SERVICE (8Y AODREBB)y��I6__�Q C����� { �A BLK._�O __LO7_iJ`__��R�� //� <br />/1 ,Q �'7�/,{�,(� y' _'�l �b�Nfj <br />OWNCR_l!!1_/�1�-�F�-Y__/J/_I_E �� � <br />- � - - - �--. _-_ CQNTRACTOR :� <br />FLAT ---� <br />� . .' -.___ - <br />� _. <br />INSTALL ____ RED SERVICE-. j . <br />I HEREBY APPLY FOR TNE USE OF WATER IN ACCORDANCE WITH THE � -� <br />ORDINANCES AND POLICIES OF 'HE WATER DEPARiMENi NOW E%ISTING <br />OR AS SAME MAY BE HEREAFTER CHANGEO. <br />sicn�eo: x _ - --- - i - <br />MATERIALS � IN. 1 �N. 2 IN ' -� -----� � <br />� � PRCE � AMOUNT <br />��FE_ COPPER GALV.--STEEL � � L <br />CORPORATION — — � —I --- __ <br />�CURB COCK�% OT — - �-- _ <br />' —__ _ � .—I_ <br />SERVIC� BOX PLASTIC •• C I I - <br />MET . !ALVE _ � -- I— �— - -- _ <br />METEIt No. .- - ___. _7VPE: --_ _-_ _i .. --.�J_._ _-_ __ __— - <br />I I <br />_METER BOX CONCRETE SMALL LARGE,^ � <br />�11 _ '_ ______--__--_- _�'--_' __ ___ . <br />- �z �ad_�_�—� G � `_.—� — I ; I —! —� — -- <br />ON <br />DATE INSTALLED: <br />- �' - /� � 7 OFF <br />COOE I L�E04 AND EO-'IPMENf RENTAL <br />- I ----- ------ -� -- -- --... —_ s! Q .ii%/� <br />_ � —_ _ _ � ,��A' <br />� /Li.3 �_ ',`_'' <br />--' --- � ���'�. � <br />� --- ' - <br />-� --- _ <br />--. - - <br />REMARKS: <br />�—f --- --�--- <br />_ � -- - — — —. <br />SUB TOTAL <br />-"-I HOURS RATE -- <br />I—`-i-- _ <br />TOTAL <br />