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WATER SERVICE AS-BUILT SKETCH ACCNT # (to be ACCURATELY completed by owner or owners representative before water will be turned on.) Sketch shall include: distance of water service from water main to curb stop; distance from curb stop to building; ties to corporation and curb stop; depth of service; location of all underground utilities in relationship to water service; and ties from permanent structures (ie; buildings, manholes, catch basins, etc.) DATE INSTALLED:
INSTALLED BY:
SIZE & TYPE OF SERVICE MATERIAL: OWNER OF PROPERTY: PROPERTY ADDRESS: MAILING ADDRESS:
I hereby attest that the above information above is true and accurate, and that all work was completed as prescribed in the Rules and Regulations of the Shirley Water District.
