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x ��v <br /> I I o � � OR SERVICE SERVICE No 1 773 � <br /> � ATION F <br /> APPL � /� APPLIC ORDER <br /> "°. ,� lC;�� ll� ITY �F EVEREYT WATER DEP�. � �,_�--19�]�' <br /> �, ��� � � , <br /> C. " L D onT[— <br /> � FIXED 1 � �C��ts.ti.-G� W.O. <br /> i �l I � Z � I �C.✓ "L. No._- <br /> i r��f7EPO5IT g �L C NC�- W ,, / ,. f��(L�.�-,/,S <br /> 1L.— ` -�� . BLK��C�LOT/�'��0�6�i'-' F!A�—' <br /> � SGRVICE (BY ADDRE69)���/ " q �i�'�"s '/r <br /> ' OWNER�Yl..'1�� ��----'-`-" `" �---CONTRACTOR----- -- <br /> �I �/, 'i FLAT _ --- <br /> I iNSTALI�/ y�--��SERVICE------ ����//��_�,� <br /> � I HERE6Y APPLY FOR THE USE OF WA7ER IN ACCOROANCE WITH TNE �.� / -'l!/ '^-'O- `i''� <br /> ORDINANCES AND POLICIES OF THE WA7ER �EPARTMEN7 NOW EXISTING SIGNEO:X -� � <br /> I OR AS SAME MAY BE HEREAFTER CHANGED. —�-' pR�CE qMOUNT <br /> AIATERIALS I �n IH.I 1��N. 2�—N I J <br /> l <br /> � COPPER-- GALV.--STEEL _I__-I— — _� <br /> � PIPE <br /> � CORPORATION � �I <br /> �CURB �3GK �T_,J ____- -- --I I -- __ <br /> PLASTIC --� _ I _ I <br /> � SEFVICE BOX- __. ,— <br /> � METER VALVE __----- -I-- ----- '— - � — --- <br /> �_—__'._-__ TYPE: I I __�-_ _I__._- . — _ <br /> � METER Wo.-.____�_ __-_-._.__ . __-_ -- . <br /> SMALL LARGE��_I____ —I----- - <br /> I METER BOX CONCRETE __ _ . — I <br /> I <br /> � <br /> I /> ---C T-� I -- -- - <br /> ` �t��cQC�.`��'d'� � - -- -- ,-- — <br /> i- I I' - -- <br /> '�_ ----- I -�_.- -- - <br /> ------- --1-'�.�--I, � - I <br /> � -- --- I i � � �' <br /> ��_ I y�N <br /> 1 Cl -F� � �n SUB I�OTAL <br /> � DATE IM1STALLED: 7 MouRs rsAT� <br /> � GOOE I LABOR AND EOUIPMEN�f RENTAL <br /> � <br /> I _"_ . _ � <br /> �-�%'-_2':Li:.� '. __—___"_— . -_ I _ _. <br /> � __ __ <br /> � I - --- - ��- --- -- - <br /> � '��,�m-�- -------- I__ -- <br /> l i ' -- _ -I-�-- - _._. <br /> � <br /> � '�_-- - -- i - - _ _--- --- <br /> � - - . <br /> � �---- - ------ - - - --i - <br /> I TOTAL I <br /> I.__I_ �- _. <br /> � � � ' <br /> - .__- -._-____._-'_. <br /> I REh1AFKS: '._-_-_'-_--__- <br /> - <br /> ____- - __._ <br /> ._ ___ __-__.- .. <br /> �- .-.__.______ . _ -_- <br /> I <br /> I <br />\ _ <br /> �..� <br />