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� NOF����� APPLiCA`fION FOR SEBVICE seRvice No z2�2 <br />ORDER <br />CITY OF EYERE7T WATER DEPT. <br />� FIXED �ATE. .�:4L.�i IJ _. .ts71,_ <br />�-u <br />, � OEPOSIT i2.) V_._ .__. W.O. _ -_ _.__ __ . . _ <br />No.. - <br />� S(� S E�.� A-( T.�c{�iC� �-�� i:,l� <br />SERVICEIBYAODRle�l��'" "l_il_ r�tiy_S_�a�..-:N�f19r'11Ski_BLh.___-.-LOT____-'ADD..-_. <br />I OWNER��`.����-_I��-:�IS�-S_.________.__-_.__. _..__CONTRACTOR _�_II.I./.i��I.CV _ _-____..__ <br />� 3 , <br />I INSTALL_/¢ — ETERED SE�.VICE . <br />I I HEREBY API'LY FOR THE USE OF WATER IN ALCORDANCE WI7H THE � / ' <br />ORDINANCES A�'J POLIC,ES �F TNE WATEN �EP�RTMENT NOW ElISiING �' <br />I 2 LL I L?7aA[� �. -�_ _ �L'. o J"��, <br />ON AS S�ME NtiY BE N�REAF7ER CHANGED. s�cw[o: %�I_�___ r� _. -.-- <br />— <br />i NATEPI�LH ��4 IN. 1 IN. � II IN. �.� PPICE I�MOUNT <br />L— —I-- <br />' PIPE COPPER -- 6ALV. -- 57'EEI- �'7.2 I ��I I -� <br />� CORPORATION __ _ <br />�_".__-_' <br />�CURB COCK_ OT _ __ ____ <br />SERVICE BOX ___ PLASTIC •_ G I <br />I METER VAL�'E <br />METER No. . _ _ .. . � _._ __ TVPE:. _ . _ I �4_ _ . <br />�—_-. ..___. _ __ ___-_- . _' <br />I M T.€ E� OX CONCRETE __ SM�A �LL LARGE <br />�— 3 ; w .r <br />�_�3 _ X 3_ S>G c u ��o �Ar -- <br />---- <br />--- <br />� -- -- ti�.c_r.y S �.+h,_/f _ --' <br />� _ -�.� - - - � <br />�---- --- i <br />�� ___ --i <br />----- — <br />�--- ---- - - - - -- -. <br />I <br />� / ���N I <br />' �ATE INSTALLE'D: �- z �^ 7/- I � OFF <br />� v <br />COOI E I �_ L�BOP AHO f.QU1PMF.Nf FENlAL <br />/ <br />_ - I __. _I __1 _ ----- -. <br />~—I �" �� '; S/. 4: % / �vr r i n} f4 l�ef � I <br />_ _ _ , +c�f. — __ . . <br />�— ---r �f -r � <br />I Lt/,s�:�c sf i��._dt_�4�t'��_c�G� .rt<.7',�a���C.�_ <br />; ---- - _�� �` �-� z � 1:6NFY <br />�— U � S � Mr <br />� _ <br />i � _ 33y- <br />- -- <br />�---- � 2_ _ 3 �,S=�H�: <br />�-- � -----_ �� ��J�=N�1 <br />� REMARKS: <br />�'_' _____.._. __'_ <br />SUU TOTAL - <br />MOUP4 RATE <br />�- - _ _ <br />(� - — <br />� _ .8. _. ��_ —_ _ _ <br />� _ - -- <br />_ tp. <br />TOTAL <br />