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~: ACCOUNT # t {; "D..O If. ';-(J {J ./ . :j
I. ADDRESS liP 770 1I~1/I4 Trn~ ( <) ~ '1
l OLD Me:eR ' N~ METER 1
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r'~ler,No.-J 1.)(.. 3a1i- s.,,~
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. . R~dJng {rtJ$77 O. v'
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. MIU Ser. No
Reg. No.
10 GCI (
@ jP~
Size
I
COMMENTS'
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OtJ5")87 fs~,
~U Phonet
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8ldg. Ty~ :
Port 1
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RPZSer. Nn
RPZ Installed Yes _ No __
I'?'
Service Size
Ground Yes _ ~,
t
>"0 Type
Lead
cop~rX- Iron PiPf'
Please keep this receipt for your records. The final reading from your okfw.rmeter
will be used in dete~ining your next regular bill. '"
If you have any questions or problems. please contact the Water Department during
normal working hours. Thank you for your coqperation. .
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INSTALLATION ACCEPTA7JBLE WATE,R,,_ M"ET,E"_""",R"""",,SE_, A":R",W""I",, ,Ii'""',N",,, P", LA, C" E,
OCCUPANrs SIGNATUIlF .. D d I . -t.- ,". .r. u<' ~
DATE 9-1 ~ - Q::l ". P.HoNe:("~a.f'!.~;J.^~~~rJ.i!:l.
Form 90080 (4-93) Copy 1 Customer Copy 2 WS'" 'Copy 3 & 4 WD
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