Laserfiche WebLink
, , . , . <br /> A7�3a N E SC N_ 1265P PP ICATIO FORSERVICE ERE <br /> , -, ' <br /> Nc�.S6.3 CEE .ATER <br /> DEFT. ' TEL4464 j /i-- 7, <br /> 0FED � , <br /> t DEPOSIT $ /%7.,. c .,►.:,:., . • W.o o. <br /> N <br /> SERVIC (BY ADDRESS) `�' / BLK. LOT- ADD <br /> i <br /> OWN /rneit.FCd-rt ` � 12t41.t:{r1, l L-Ly/ CCONTRACTO <br /> _1_,,..... , .: ... . .. <br /> INSTALL METERED'SERVICE. ii „7.1.i., ,;,4,, f - . <br /> I•HEREBY APPLY. FOR THE USE OF WATER IN'ACCORDANCE WITH'THE <br /> ORDINANCES AND POLICIES. OF THE WATER-DEPARTMENT-NOW';EXISTING . • <br /> OR AS SAME MAY HEREAFTER CHANGED. . . • SIGNED: L�..c r -. <br /> MATERIALS %IN. I IN. 2 IN. I PRICE ' AMOUNT <br /> PIPE GI:1"‘DE-W-GALV.-STEEL 124.h a?2� 4� j7 <br /> • CORPORATION . / . --I b--/ <br /> CURB COCK ` • •OT . . I I <br /> SERVICE BOX PLASTIC - C I I <br /> METER VALVE 3 I • 7 3 61 <br /> METER 14o.SA16-10f3 1erg'TYPE: I 4 . ,—. rrJG <br /> METER BOX CONCRETE SMAL LARGE / ' Q <br /> . •, C*-4:ja t- ?et I 11- 144e <br /> .) <br /> 7L.41*.. 71/...'' <br /> ON <br /> DATE INSTALLED: f 1 w Z d r-,kOFF-// I SUB TOTAL /23 •g# <br /> CODE LABOR AND EQUIPMENT RENTAL HOURS RATE <br /> 0-,Gaci /e 4-6 <br /> _, i, ( 9 3,971 is`iC¢_ <br /> : • p 1t ? --- 12 . ?SO 7 oa <br /> I <br /> ,d 2 <br /> ,, . TOTAL.. _ill <br /> REMARKS., � �- _ �2_ <br /> di�rir - ,)j, - 2.'is 7;-/ 7/ /lAr, Scar v,,c4 Cv S° _ Me <br /> C� 'Z.6 5 ;fir �'efc4' � '' /f' C',•r os." <br />