Laserfiche WebLink
APPL.� a.-� _�,.� ��� SERVICE <br /> Na• '�' ' CITI� CiF E1/ERE'T OROER NO. <br /> APPUCATION FOR WATER SERVICE <br /> � FIXED DATE . �I__��-�- . _ ��' <br /> 19__;� <br /> �DEPOSIT 5�_`���.` C.� � �. ' <br /> ._t_L.-_ W. O. <br /> No.- _ <br /> SERVICE (BYAD�HE88)�=L-� �lc.:Tf-1 �i BLK._-_LOT qDD. <br /> OWNEA� "L�-��1 .'L�. 1A-G�L/�� ;"7Y�1�,� _ _CONTRAC70R__ <br /> ' ' � FLAT - ' - -. <br /> INSTAL ETERED SERVICE- <br /> I HEREBY APPLY FOR THE USE'�OF-WA;ER_1N_�t�ORDANCE WI7H THE �� / ��.' <br /> ORDINANCES AND POLICIES OF THE NATER DEPARTMENT NGt4 EXtS"ING L� --_ �(„L� <br /> OR AS SAME MAY BE HEHEAFTER CHANGEO. sicNeo: X ��` - <br /> MATERIALS I Si iN. 1 IN. 2 IN. '� <br /> I L_ PRIGi" AMOUNT <br /> � ��. <br /> '_PIPE COPPER - GALV._ �'TEEL �I- - .. . - .T <br /> CORPORATION _ __ I I �� <br /> CURB COCK PT __ I � � <br /> - - --I___ <br /> SERVICE BOX PLASTIC - C I I � — <br /> _'__'__-___" '-. ' _- <br /> - _ -_ __-' <br /> METER VALVE <br /> _---.____- __—_ _ ._--.— <br /> MET[R No. _ .._—__--- 7VPE: I i` —___.__,_--_ _- _.- _-- <br /> ..__ __ ._ _- ._._I____. ._ _ <br /> METER 00X CONCRETE SMALL LARGE <br /> -.-. . ._-___. _ _ '_ _ . '_____ .�I._'-I I—_L__I-�- __— <br /> __-'- .__ _ � I 'I— - -_ - <br /> -- I --_-_ <br /> __I i__ _ __ <br /> '_- _-__' "_'__-_- <br /> I � � _-_._ - _- <br /> I �e�N <br /> DATE INSTALLEO: r� G��7 � OFF SUB TOTAL <br /> �7 / / <br /> COOE � LABOR AND EQUIPMEt�f RENTA� � NOURS RATE <br /> I _. I <br /> _-� � -__ <br /> - <br /> _ <br /> -- -� -- -- -� — �- J . . ---i— -- -- ---- <br /> _ ...( � � . .---._.. . . _. <br /> -- ---- ---- <br /> _ - - <br /> - ------ --- <br /> --- __,5&E_ flrr�cyF.o _S _N_��y's -- I — <br /> — L-�1l_�rs�T.�.�isyL . -- - � <br /> � —�--- ---- <br /> TOTAL <br /> REMARKS: � -"- ., <br /> - �� <br />