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w���.�D(,�O � APPLICATION EOR SERVICE aercviccN� 1�;)�1 <br /> No. � U / O � CfTY OF EVERF7T WA7ER DEPT. °ROER l� / <br /> �FI%ED DATE�S�L.��_�f8—___ <br /> � DEPOSIT s , ^�v� W.O. " <br /> No. <br /> SERVIC! (�YACDPE^{�) '�n��� �/^�G�` �C� BLK. � LOT_�ADD�L��Fy(�'r�� <br /> OWNERL'/�v/L ��C���i�L'/ __CON7RACTOR �SAsI/� ___ <br /> � FLAT <br /> 1 NSTAL�,3�MtTlRl�'#GE <br /> 1 MEREBY APPLY FOR TME US[ OF WATER IN ACCONDANCE WI7H THE � �V(�{ _ /�Jt�{'R� ,r <br /> ORDINANCES AND POLICIES OF TNE WATER D[P�RTMENT NOW EXISTING i � U <br /> OR AS SAME MAY BE MERE�FTER [HANGEO. s�cHeo: X — �� <br /> ��'�_--_ <br /> MAT►111AU ' 1i IN.� f IN. I IN. I PRIC AMOUNT <br /> PIPt COPPER--GALV.•-ST'nEL <br /> CORPORATION <br /> CUfiB COCK OT � I <br /> SERVICE �O% PLASTIC • C I � I <br /> METER VALVE <br /> MiTER No. TYPE: ;f <br /> MlTER BO% CONCRETE eMALL LARiiE <br /> _ t / ' / .-` , {_. ' -.^I _- -- _—'— <br /> /I,.�'7- � '1/' _(�_�✓.' � __I — — _ <br /> ,7— � %� -� � I <br /> �-� ��i �- � � — — - <br /> - _ — —� --- — -- <br /> - ---� �- � i -- - <br /> �i oN <br /> DATEINSTALLED: I L� OFF SUB TOTAI <br /> CODE I LABUP AND EOUIPMENtRENT�L HOURS RATE � <br /> __I�• J I <br /> --.-___-.-. - . _---I_�- .- - - <br /> _.-_�____T_- ._-_._ ___-- - __-- �r- _ __ - -__" <br /> ____ __ �" __- __.-- -- <br /> _�_—___ — _.—'__ —_ _-- . —TOTPL <br /> REMARKS: . . . . 1/ <br /> __ / ,___ __. .. ._ . � . . . � . ___-_ ___ .. -. .._ �•t ♦ L(�` 1 r� �� <br /> T <br /> l <br />