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t� <br /> � <br /> � <br /> M <br /> N <br /> i' <br /> rd <br /> G <br /> �I <br /> � <br /> ���. . .i. , , � i;i����� �F ��,i�-1'�i i� - ' _ � - f��o � � � I <br /> C' <br /> No �/��� �- ' "�..;�if� v_ � '�J : '. p�� <br /> APPLICATION FOR :'JATER SERVICE � � <br /> � � FIXED f ��.�� TO POS�I���1�J.��CI �d�� NaTE��I�---18�L_ <br /> � DEPOSlT W' �' <br /> SERVIGE ce/�y`�wooRusl /���� ��/ BLK.. LOT 3� ADD. <br /> OWNER C�� � ��', - CONTRACTOR . <br /> �FLAT <br /> �NSTALL-3/ METERED SERVICE_- _. - - - <br /> I HEREBY APPLY FOR 7HE 115E OF WATER IN ACCORDANCE WI7H THE / � � <br /> — ___- <br /> ORDINANCES AND POLICIES OF THE WATER DEPARTMENT NOW E%ISTING /4�i/1 ��1 /�q � Q/� //� <br /> OR AS SAME MAY BE HEREAFTER CMANGED. BlcraEo: X ll��(N �i y� t/� <br /> MATEHIALS � IN. 1 IN. 'i 2 IN. I PRICE � AMOUNT <br /> � � � � <br /> p�pE COPPER-- GALV.-- STEEL I <br /> CORPORATION _ �i_ r—_� <br /> CURB COCK OT - - - �I I —� — <br /> SERVICE BOX PLASTIC -- C I I <br /> METER VALVE I— I__ ___ ____ __ __ <br /> METER No. ( ���_ __TVPE:Ne�LC/�I �, _'__ I_ � --_ <br /> METER BOX GONCRETE . _ SMALL LARGE _ I �___ _I_ _ _ ___ _ <br /> _--__- ..___ __I—_�I_— ' <br /> -I I i <br /> ' _ _—i _I_— —" <br /> I _�__ - _ <br /> — _�— <br /> _-. --__- — �i i I <br /> __-' __----_- I _-�i i . — <br /> �^ SUB TOTAL <br /> �oN _ S . <br /> DATE INSTALLED: /O-/GL -�� � OFF <br /> CODE i LABOR AND EOLiP,aENf RENTAL I HOl1RS RATE <br /> I -.__—__ _ — _ __ <br /> � <br /> I I <br /> � --- ---PJt�RLiFI M1l-- --- — <br /> ' ----------W�tl-b�-fiaken or� servi ce <br /> � — —�P(�11rK 1tac�s—w�4�r>�t—a— <br /> � _ [3ack(lord Prevcnticn �on3ttlta6 <br /> --i � <br /> _ I <br /> TOTAL <br /> REMARKS: C��-�'L ���3 _ _—_._ _ — <br /> � <br /> � <br /> My <br /> t' <br /> � <br /> e <br /> . <br /> � ".` --_-- �a - � � •�.•.'4`7j:�.s'� <br />