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� �P����� APPLICATION FOR SERVICE SERVICE No Z� 36 <br /> � No. � � ORDER <br /> CITY OF EVEREST W�CTER DEPT. � � / '�� <br /> � �fIXED DATE__.�._Zl._- __19-L <br /> � ,q-� U <br /> . � UEPOBIT s �Q(�, � No�— ______ <br /> SERVICE 1(eYwDDNEee) ���.�v4��L�i/+-+� `y���BLK.—..-LOT� _ADO�-�E�UK��D <br /> i OWNER�+� ti1 /��U.�_--__._CONTRAC70R__. ______ <br /> �� �FLAT --- <br /> INSTAL `�' �rcorr+ �c,RVICE.�_-_- <br /> � 1 HEREBY APPLY OR TNE USC OF WATER IN ACCORDANCF. WITH T4E <br /> I OPDINANCES AND POLICIES O� THE WA'iEN UCFARTMEN7 NpW E%ISLNG �' <br /> � <br /> OR AS SAME MRY BE HEREAFTER CHANGED. sicHt�. Y, v„ti/�v/�{�y�`J. <br /> � MATERIALB }j 111.� t IN. 'i 2 IN. I I PRICE AMOUNT <br /> . P�PE COPPER--GALV.•-STEEL � <br /> I CORPORATION — � � <br /> CURB COCK OT I � <br /> SERVICE BOX PLASTIC •- C I _J � � <br /> . — _ _ _-_ —�_ —' <br /> I METER VALVE <br /> � METER No. — __. "_"__- TYPE: _I M_ __ --_I.- _ __'-'_ _- -- <br /> I METER BOX CONCRETE SMALL LARGE � I � <br /> � � <br /> �_ — _i �__ -_ — _— —' <br /> �___ I I <br /> I _—I I -_ _ — <br /> I _ -I �J_—' _ -.- <br /> � <br /> `_ _ —___ _'- — -- ___ <br /> �— —-- --- ---I-- — I — —I-- - - -- <br /> rb ON <br /> I DATE INSTALLEO: �` /- 7 /- � OFc ' SUB TOTAL <br /> � �� �- l �v <br /> 1 fD9E j LABOR AND EOUIPMENT RENTAL I HOURS R�TE <br /> r---, - . � <br /> i--'----- - --- _ _ - - � --- ---�--� --- -- <br /> ' -� -- <br /> - - - ,--- - <br /> � ' J7 � - - �-�- -��- -----� - - <br /> � - l� �- _ -- - " i <br /> -- A� ��--- - --- -- -- --- �- — ----'---- -- <br /> I--I ---—�`-- I---- ----- -- — <br /> � <br /> — ---------- -- . . . ._. . _ . - . <br /> ._- - -- - - - ---� -- -I- -- . ._--- <br /> �-- — <br /> �— — `- -- � -- <br /> I TOTAL <br /> I REMARKS � - , / . -/ <br /> /��/-L/ -- - <br /> I – ! r .LL ' ` (�G/_'//1. i z � . . _ . __. __ . ._ _ _____._. __. <br /> �� � - _ __ __ __ . — _ <br />