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ACCOUNT #
/ ."1'S 10;'1 @
J - .
/r5lf~ F h 4 Po,-~ yt-10I
ADDRESS
OLD METER
NEW METER
Ser.No.5~1~~()g- i:.
Up l.fJ!rP:x,: :::NO.) / g J () G4 \
S- 70&() q
Digits
Readinp
MIU Ser. No.
MIU Phone#
Bldg. Type:
Port 1
2
RPZ Installed Yes No
RPZ Ser. No.
Service Size ''%
Ground Ye~'NO_
Type
Lead_ Copper ~on Pipe_
Comments:
Please keep t~\receiPt for your records. The final reading from your old water meter
will be used in termining your next regular bill.
If you have any uestions or problems, please contact the Water Department during
normal working hours. Thank you for your cooperation.
INSTAL. LATIO.N A CCEP.T. ;a.~L~~TEiJ'1E~~. S ~..' WIR: IN PLACE.
OCCUPANTS SIGNATURE' III./ 1 (1) ~
" . . .0. ( -
DATE 17 -- ( q -~, PHONE /ft.fr) - ~a 1P
From 90080 (4-93) Copy 1 Customer Copy 2 WS Copy 3 & 4 WD