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ADDRESS
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..gllLl 'SUy1~et tr. 50 ./
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Port 1
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OLD METER \
NEW METER
Ser. No.
1 CW r"f t l.f Lltl ./
Reg. No.
Size 5/q ()OOOOCXJ"~
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_ MIU Phone It
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Bld~~
6C}~."'1
RPZ Installed - Yes _ No _
RPZSer. No
Se~ce Size
GrOu;d Yes ~o _
"0 Type
Lead
Copper -2lronPi~ -:.
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'COMMENTS'
Please keep this receiptfor your records. The final reading from your old water meter
,; will be used in determining your nextret~l~r bilt .. _ ,- _ _ "
If you have any questions or probtemstlJi_econtact the-Water Department during
normal working hours. Thank you forye,ijfob.rat!on.
- - - - - - - - - _.- - .----.~ --.,.. - - - - .~ - _. - ---
'. ;NSTALLA TION ACCEPTAe~ ~~~1S~R SEAL \V.IRE IN PLACE.".. .
OCCUPANT'SSIGNATURE~ ~
DATE ,q/~/:z.~ . PHO . .
Form 9OO~edll''' . -COW l'e~, . Copy ~ WS Copy 3 &.. we
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