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A N P L�,.�..-1/�"�' I <br /> �.;. . . . � Ci 7 f l'ir EVER[TT seavicr_ <br /> APPLII;A'IOhI FOR IVA-fLR �ERA%ICf_ GROER I�JO. <br /> L I FiXED DATE__���_�' _. I9 ,/ <br /> ^ DEPOSIT y �"7 y" ' -_ <br /> - r-_ . _ W.O. <br /> NO._______ <br /> SERVICE IBY AODREBBI � Z�� � � /� y�+ /( � <br /> . -- [3��_YJ/r _l�iu_C':__6LK. '__'LOT_1-2' ADDLd��/L',��!_.� <br /> OWNER_�.L�X�<Ly� y___ . _ _'�1Y`j2__ __ . _______CONTRACTOR- _____ <br /> "7/, '� FLAT-. ._-_�_ ___.-_- - <br /> INSTALL-��._��TERED SERVIC�y._ . . <br /> ____- ___ <br /> I IICRCOY �__'-_'." - ._. -. _- __'- ___ . <br /> ORDINANCESPAND OLICIES OFETHf WITER DEPANTMENT NOWWEK STING /� <br /> � <br /> OP AS SAME MAY eE HEPEAFTER CMANGED. eiGHEo: X .�(,`¢�.,�.� _ _ . <br /> MATEPIALB ]G IN. 1 �N. 3 IN. I I PP� AMOl1N1 <br /> I � <br /> PIPE� � : .,_r .__ ___COPPER- GALV.--STEEL____ f —I I �- <br /> 1_ <br /> CORPORATION r � -� � / � � ' � � � <br /> -1'__ __ - <br /> CURB GOCK _ OT_.___ . . .. __ - T --i -� - <br /> � � <br /> SERVICE BOX____'_ PLASTIC -. C I _ -'-I -'-� --- -- <br /> . -_. .— �_.__. <br /> _ METER VALVE . I � I <br /> _ -- <br /> ____ <br /> MEl_ER BOX _ CONCRETE SMALL LARG ^ If � � <br /> METER NO _ TYPE. � <br /> __ E j ! _ ' ___- . <br /> - __�.__�_ _'_. . _ ' _ _ .. I_�—�'—i_. _ - "_ _ _ _ <br /> . . . .-1�1_.-�— I / I _ _ -_ . - .. <br /> -_ _ _- _-_--__ '—. � -; _ .. _ -_ _ <br /> - - - -- ��-J�- - - - <br /> I I i <br /> � ON <br /> DATEINSTALLEO: � <br /> '� � � �� �-�/� `l� � � OFF SUB TOTAL <br /> COOE L�BORANpE0U1PMENfFENTGL HpUPS ppi[ <br /> - ___ - _. __ _ � � � � � <br /> __. . .__ __-__ . . . : <br /> - -:- � ��9��J -- -; i --- _- � _ <br /> � � <br /> _�'- — . . __-_ � TOTAL I '��, •� - <br /> REM1IARKS. -- <br />