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����. a�a 96 eanvica �; <br />No. CITV OF EVERPTT ORD[R NO. � f� J rJ <br />APPLICATION FOR WATER SERVtCE �f�/! /' p� <br />� FIXlD DATl.l`��._�� _1Yi� <br />% <br />�OF.r061T W. O. <br />S '--__ No.—___— <br />r � / -! -t�Ho���i'�.�- I <br />senwce u. � �.n % =/��h _ _�� e�K.__—�or_ <br />a �f <br />OWNE � _ �✓_.__f�",�aL_ _ _ _ _CJNTRACTOR__--_—._ <br />�/ '� � l.M� . .—_._.__ <br />INSTALL�/!/.___METERED BERVICE—._.. _ _. ____ __. <br />I HCRElY APPLY FOR THE USE Of WATER IN ACCORDANCE WITM TNE /��/J L <br />ORDIN�NCES �ND POLICIES OF THE WATER DEPARTMEN'i NOW EXISTING �� � /��-- <br />OR AS 511ME MAY BE MEIdAfTER CH�NGfD. nar�co. /�"'hr _/ _ <br />M�T[I.UI� W IH. 1 IN. , t I� I P111C[ �MOUNT __ <br />rIPE COPPER •- GALV. -- STEEL �I ' I <br />—_—______ __ ' <br />'—_ __ __ __— _ ___ _ '__'_ _— <br />CORPJRATION __ _ r I _ <br />CURS COCK OT I I� <br />SERVICE BO% PLA9'fIC -� C I I <br />MF_TER VALVE --�. .— . . . — - � � -- ---- — <br />i <br />METER No. 7vFE: I •. � I � <br />_ _ . _. . _ _ ' ,. _ _. _ — . ____ i .. _ __._ _ .__ _ _—_ <br />METER BO% CONCRETE SMALL LARGE i <br />__--. _ ___ .. . . . � _— _ _ ___.. <br />I i _ _' — <br />. --.—__ . _ _--_.. __.._ .. _ . — <br />--- --_-- —_' . I I_ — _ —__ . <br />" '—'I ' <br />_ <br />_ .__ _. _—'__— __ <br />—__ _ <br />. _ —_ __._. __ _ _I —'_ _—I' _ ..I ._ . ._— __ '__ — <br />—_ __—___ _ . . .__ '___'—._I'—_I—_ —' _.. _... _ _'_ ___ .. _ <br />� ON <br />DATE INBTALLED: ta��JS�pV f� OFF SUB TOTAL <br />�� O <br />COD[ � l�loR �NO EOUiIMENf RENT�L i HOUR! RATE <br />I —__ _—__. .. L�.��/A�G��__—_ __I _ <br />� <br />. . _ ... . _ —' __'__ <br />. .... _ . __. _.. . _. <br />-� - �i%�� 0 0 / _-- �- - - - - <br />i-_ - __ -_ - -�-- -- - <br />TOTAL �I I <br />REMARM.S: <br />