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A►'���� m[AVICQ I <br />No. CITV OF � JERETT oRou N0. -� ���' � <br />APPLICATION FOR WATER SERVICE DAM6�� �� —'.�L <br />Y�I <br />� �izio p <br />0 w. �. <br />� ocrosir �_� 6 � _ Na.-- ---- -- <br />1 ..►- y 3�_ �_ <br />SlRVICE (w __��.V1'7f� � ��/Joy�y4C��z�� _BL(.._- —LOT- -ADO.� <br />OWNC Y---=�/ ��l%�''� CONTRACTOR. __-._. . _ . _. <br />�� q �- _- <br />IN6TALL-7'- �[D 0lRVIGE' - - . '- ���� . _. _._' _' <br />_ -.__'--' - <br />I HEREEY APPLY FOR TNE USE OF WATER IN ACCORD�MCE WITN THE <br />ORDIN�NCES AND POLIqES OF TNE W�TCII DEP�IITMENT NOW E%ISTING �ioHco: X � - -- -- - -� -- <br />OR 119 S�MC MAY !E MERE�fTER CH�NGED. -- <br />M/�T[III�U K IN, f IN. � t If� I PMC[ •MOUNi <br />� <br />PIP! COPPER--6ALV.--STElL _. ..I.___ . _... _ -__ --- <br />... _ _'_ -_'_ .___ _. _- <br />CORroRATION __ _ _ '__ _'______ _ ' _ _ _ - - --'- -' — <br />CUR! COCK OT � - --- -- — - <br />. ____-__ _ '___ '____ _ _� i <br />__ ._ I <br />6[RVICE BO% PLAfTIC C I .. . - - � <br />— _ -- <br />M[T!R VAW[ .__ '. - '-__ _.. _ — --. ' __ -' ____ <br />__— _.-_ _. - .- __ - <br />M!T!R No. . __ _ ' _ - 7YP[: _ ' I ._� _ — _ _- II — _ -_ <br />MlTCR 00% CONCR[TE ._.._._ SMALL LAR6C__ __,_' _, _ <br />- --- -- -- - -- _ _ � —� --�- - �- I— <br />DATEINSTALLED: <br />�oo. i <br />—i � <br />—i — - - <br />I � ON <br />'L���I I � OFF <br />Ll1lOII ANO LOUI�M[Nf 11[NTAL <br />w <br />- � y�3�a'f <br />1 _ -- <br />� <br />' - -- --- <br />SUe TOTAL <br />NOUMf 11�1[ <br />5� T i / � _ <br />1 '� <br />- - -#"Ll{ ' l " <br />--a-- -- ---- <br />REMARK3: _. _ ._ . <br />