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HomeMy WebLinkAboutWORK ORDER - 04-00243 - 680 Meadowbrook St - New SFRWORK ORDER 04+-©0D43 ACC# RT# PHONE EFFECTIVE DATE DATE NAME 2 A// ut^ a� ❑ WTR.SWR ONLY SERVICE ADDRESS / /Yi R A cidw �j ✓aa,E MAILING ADDRESS G 5 ? `l ' ! l3 N OWNER T;rewrs 4- {)/1- A A PHONE NO. OF PEOPLE ADDRESS EMPLOYER OR RELATIVE WORK PHONE COMMENTS SS# SIGNATURE ❑ IN ❑ READ ❑ ON ❑ RE -READ ❑ OUT ❑ CHECK LEAK OFF ❑ WTR.SWR ONLY ❑VACANT ❑ GR CONT. # METER SIZE GR RT# LOCATION COMPLETED BY ❑ RENTING DEPOSIT AMOUNT ❑ BUYING DATE PAID IN ❑ SELLING REFUND DATE ❑ OWNER AMT REFUNDED ❑ BL CONT # AMT. APP. BILL S BIN SIZE NO, OF BINS 11 11 11 El 11 [1 ISSUED BY APPLICATION FOR REXBURG CITY SERVICE NAME(� 4 U1 ADDRESS 60r ❑ COMPUTER FILE ©/4 _OOa43 PLUMBER VV•�^^�� PROPERTY OWNER WATER SERVICE: Type SFR Size Water Connect...... $� In City Out of City Water Meter........; Meier Box ......... $ Storm Drains — $-._._.._ Ring 8 Lid......... _ Curb Stop ......... $ Setter .............. Sewer Connect ..... _ TOTAL............ APPROVED BY