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i <br /> yroy <br /> 10 TW <br /> F <br /> )P�,f IL �c•, 1,.�.i 5 iS .v, <br /> 0 ADPL. � •[DEICE No 6987 <br /> 7 r+y CITE OF WATER <br /> S ORDER <br /> G1 No. OL � , APPLICATION FOR WATER SERVICE c- <br /> M r, DATE <br /> N FIXED <br /> �( a W.0. <br /> N t+ � ❑ DEPOSIT f �I/) _ No.— -_ <br /> Q A y f O — \Y \V• 1 1 - __�L_ BLN. -_._ - LOT .-ADD.- - - <br /> IIIIHM�a�t �E SERVICE ISr Ao0[utl—.l ��_ <br /> D <br /> in OWNE .CONTRACTOR__ - <br /> - <br /> 7 T 2 <br /> INSTAL v D BERVICEi_���`� + <br /> RDANCE <br /> ITH <br /> ORDINAe CES A D POLICIHE ES OiEOF WATER IN THE W TER DEPARTMENT NOW WEXIST <br /> ING [ION[D:X <br /> OR A4 AME MAY BE HEREAFTER CHANGED ~ <br /> MIN 1 IN [IN PRIG[ AMOUNT <br /> MATERIAL[ <br /> PIPE COPPER..GALV.-STEEL _ <br /> CORPORATION - - — <br /> CURB COCK OT <br /> SERVICE BOX PLASTIC -- C 1— <br /> /c�. METER VALVE <br /> METER No. TYPE: <br /> METER BOX CONCRETE SMALL LARGE <br /> A O OFF I ON <br /> DATE INSTALLED: <br /> / ( SUB TOTAL <br /> ' i HOURS RATE <br /> _1_1 CODEul <br /> I MOR ANO[OUIPM[N!RENTAL <br /> TOTAL <br /> REMARKS: <br /> +_S, <br />