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i NOPL �(��,` hPPLICATION FOR SERVICE <br />� CITY OF EVEREiT WATER DEPT. <br />; e FI%ED <br />' ❑ DEPOSI7 s G Q�EC.� <br />� <br />SERVICE Na 2.184 <br />ORDER <br />DATE ���(�.__19�� <br />'� <br />� Q�� rvo. <br />� 9ERVICE erwoorte�a� c�U1 �($1�{�,�� ��� ( <br />I �+�C'��L.: _6LK.__ _LOT-4�_.ADD.�G7� <br />� OWNE -I �L � 1 �1.3��'Y(Z� <br />—CONTRerrne <br />i IN.,TAL � F <br />ETERED 8E IC <br />I I HEREBY APpLY FOR THE USE OF <br />I ORDINANCES AYD �.�oLIGES OF THE WATER DEPARTMENi NOWwEKISTING <br />� OR AS SAME MAY BE HEREAFTER CHANGED. <br />8'GNED: X _ <br />j MATERI�LB ��� <br />� IH. I i'4. � 3 IN. <br />P�PE COPPER - GALV. •• STEEL <br />I CORPORATION � <br />� CURB COCK ���� — <br />I 8ERVICE BOX PLAS�IC .. C � <br />� METER VALVE OL.%J ST L,E <br />1----___—__-_._—_�____. � <br />�MET�R No. / � TYPE: <br />�r_ I.D J_ <br />METER BOX CONCRETE SMALL LARGE � <br />I _ <br />�------ r k(c -£� G- 7 3� R{ <br />�--------_� '� tt1_E�LZSIty �v <br />� n <br />� i r� -r_f � � <br />� <br />DATE INSTALLED: y'�_ jC��, ��� I F�`��' <br />� OFF <br />C0=_6 � LAB�sp A:10 EppIPMEN( RENTAL <br />I � <br />r—; <br />i � <br />----� �--� <br />. __ — - 3 <br />REMARKS: � '� <br />--__—. : ��L :��-'1:�Y-�_1.—'_e'._�_. _ ___ � _ i <br />. :'/ ._- <br />�cJu�tG:� — - <br />�PA��E AMOpNT <br />� � --- <br />� _ <br />SUB TOTAL <br />MOURS ' RATE <br />