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_ _ . . <br /> �oP��c�� �ITY OF FVERET7 ORDE'RE NQ I <br /> P,PPLICATION FOR WATER 'iERV�CE � J �, <br /> � FIXGD DATE_��--.19�� <br /> r� DFPOSIT �'`�.= '•M. O. <br /> � 2C� No.—_—_— � <br /> C -r�,/ / � ��� /�/ �.. �.�F,i-L:�rG/i7�/ <br /> SERVICE (BYnoDREes) `�`-�� -._�.L��._�`�':1.`��"--BLK._ LOT�ADD.�I��✓_�'�--'- . <br /> OWNER.�/tF.C'-i At7 !'�I/G C /�ir!S �I�:^'7� .F- __ I <br /> �_i _ _-._CONiRACTOR_.�._-_".--'___- <br /> """ ` ^��`��/ � .i �F_IAT� <br /> INS'(AL�{Ly .MF_TERfO SERVIGE-__-_ __ . ._-.--__ .—.-_.--.___. __ _ __ _ L _._---__ <br /> I HERE9Y RPPLY FOR THE ❑SE OF WA7ER IN ACCORDANCE WI7A THE `/ <br /> ORDINANCES ANC ?OLIGES OF THE WATER DEPARTMENT NOW EXISTIN� / � <br /> OR .\S SAME MAY OE HEREi.FTER CHANGEO slct�Eo: - �- ��� /�I-�-�-- �--- - <br /> MAICPIALS I 3i IN. I IN. j 2 IY. I '. ( � PR(CE � AMOUNT <br /> �- _.� <br /> PIF't __ _ COPPER_- GALV.-- S7EEL �-{I-- --, I I�- <br /> CORPORATION '__'_.'____ -__ -- —I- I--.'_-�'_____� _ — <br /> CURB COGK OT � I _ _ __ <br /> 'iERVICE BOX PLASTIG •- C I I ( J <br /> METER VALVE __ __ � <br /> Af�TER No. TYPE: I SL -'-- '----- - _ _ _'_ <br /> �sE7ER BOX C�7NCRETE � SMALL LARG� <br /> __.— --_-___—_..__ -. .——I—_-1.�_- __ -- _— <br /> — --� --� — <br /> —� ---- I -��I-- <br /> — --- � � I— - — <br /> -- -- ---I ��i� -- <br /> --- ,�o,� — <br /> DATE INSTALLED: jJ_ !f-�; ��l3� I n OFi= SUB TOTAL <br /> COOE � LAI3Cl1 AMD EOUIPMEN� PENTAL � HOURS RATE <br /> � �:r., '; �—�-- --- -- — <br /> — --- <br /> ----- —— <br /> --i ----- � i � I � -- -- <br /> _ =�' �`"`_—' — <br /> -- � --- ��� --�-�l_�—� / — -- <br /> --' __. � Z -�/-� - �- - - <br /> � !-- - -- <br /> ---- - -- ------- <br /> --; � - <br /> � _ - --- --- -i _ <br /> TOTAL � <br /> REMARKS: (� G� i , , /: . � , . . '%, c' . .�i'.��_�.._._- —_—�_ <br />