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MTU Installation. Request Form
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Time
AccountName ~ 1nm .~
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Account.# 00 / l/. 1%DO
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Meter size
Meler SIN
~7cm
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MTU#
Check lhe f?llowihg:
Flow Meler seal Main on
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Installed by
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143800-
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ACCOUNT #
ADDRESS
J(LEMLEY CIR SE, 5369
OLD METER
DAY, TOM
NEW METER
.2Si>l-Jt1% 3>
Ser. No. "'12i I' .
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Ser. No. /1024" ~ \
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Digit~ ../ "",
Re~!~~ 7;;S/~D~/)
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July Read: 920000 ~ II
MIU Ser. No. -y, l... , ' 2:...u 9
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Reg.No. I
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Size '7i 1J
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MIU Phone#
Bldg. Type:
Port 1
2
RPZ Installed Yes
No RPZ Ser. No.
Service Size
''t Type
Ground Yes 1- No_
lead_ Copper~ Iron Pipe_
Comments:
Please keep this receipt for your records, The final reading from your old water meter
will be used in determining your next regular bill,
If you have any questions or problems, please contact the Water Department during
normal working hours, Thank you for your cooperation,
INSTALLATION ACCEPTABLE. WATER METER SEAL WIRE IN PLACE.
OCCUPANTS SIGr-'ATURE~1 ItA ~DV\ _~/
DATE \ t to oJ/ PHONE <r 72. 0- (0'--\ lob
;'Ti ;;00 ,...,,> \ - 1 C""""",, - 2 WS Copy 3 & 4 we
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