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0/5/03
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ACCOUNT ~ !JIJ:3fJ dol/CO .
ADDRESS / (~C)(PO (J11l0ev
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OLD METER
NEW METER
Ser. No.
3nJ~ 7S7
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Ser. NO./ ffl0J 7
Digits
Reg.No:
Size ~ N J,jd
Reading ?,tP Cj ~ t./ 3r) X
MIUSer.No. \.~~wm
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MIU Phone#
Bldg. Type:
MI"'L 1n6l1e~No_
Service Size :f!if 1/
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GroU@.NO_
Port 1
2
RPZ Ser. No.
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Type
Lead~# Iron Pipe_
Cofmenb.: fr!.t:/1;7 ~ nU; oj.. fJ1'{lG .
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~ It15/'l. r!~;C IN 'j)f.Jt~k?If~ ~ rr ~~
Please keep this receipt for your records. The f a~ om f;u~~~ ~~
wi\l 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 SIGNATURE
-
DATE 6 -S -l9 :s
. PHONE
Copy 2 WS
Copy3&4WD
From 90080 (4-93)
Copy 1 Customer