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i <br /> APPL. '� /' 7 •7 SERVICE . . <br /> rvo. �n �,�� -� CITY O"r EVERFTT or�oe� NO. <br /> APPLICATION FOR WATEHTSERVICE �//�J <br /> � FIXED �v' "� ��� 0� DATE-1.�!_1� <br /> OEPO&IT s `J�Q � W.O. <br /> 40.. <br /> � � ',�_ � � )�1 1tL�l� <br /> � SERVICE �er woorteee � �� �� � BLK._ L07L^�ADD.�LL-- <br /> OWNER__ � � • CONTRACTOR_�1 ��� <br /> ! 4 FLA <br /> INSTAL� � -Mh`7ERED SERVIC _._ _ <br /> I HEREBY APPLY FOR"THE USE OF WATER IN ACCOFDANCE WITH THE � � <br /> ORDINANCES AND POLICIES OF THE WATER DEPAR7MENT NOW EXIS7ING <br /> OR AS SAME MAY BE HEREAFTER CHANGED. e�eNeo: X <br /> MATERIAL9 �' IN. 1 IN. � 2 IN. � PRICE AMOUNT <br /> PIPE P.C�TII.__, `'��� � ' �6 _� _ <br /> CORPORATION / <br /> CURB COCK OT � <br /> SERVICE BOX PLASTIC •. C 1 I <br /> METER YALVE <br /> MFT'cR No.'�� . TYP fl���l_`6 _ ---- - -- <br /> METER BOX �iBNef!lTe�y� MAL LARGE I <br /> QvA,e�-E,e $En/D -- — LI _�__ <br /> L �� =�1 �_ <br /> - L�7� � <br /> , �z��L� I � <br /> ( ���,� -7�_.�' `�iG ,�.� — -- -��-- <br /> C 1'/�J•-%� � l�i� ,'r � / I I � I <br /> DATE INSTALLED: Q�—�o�—�j � pFF SUB TOTAL <br /> CODE I LABOP AND EOUIPMENTRENT�L HOl1H5 PATE <br /> I c I <br /> I -- --- ��� — <br /> I - ,D_ I-� - - - <br /> � ,, � �. I . <br /> � ���� <br /> i ,�._- -- ��s��s i , , <br /> I <br /> TOTAL <br /> REMARKS: .i L�j✓I� c�.�tir, � p _� <br /> �f���Fr- �>,tKr•,S ��✓G� — �_ �� v L�_G�z�__ �:: a - <br /> •`-�� /��;'./�1�� �Rt�t e�G <br />