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. _ . � ,� <br /> ..e. D. Form t tEGO d.l-�7C.P. �� �( '�'�r' <br /> C{TY OF CVCRETT==Nater Department �� <br /> � Application for Water <br /> All blanks must be fillcd in ur rroc=cY1 uut <br /> Ecerrtt.____ �/�i L._.___19] �.__ <br /> '1'�7 7'Hli SUPISRI�TLNLIiNT 01�Tiiii 15'ATliit DEPAR7'971iK7'. <br /> C17'Y OF L9LKI;TT: <br /> I hereby apply fnr the ��se u(wnter in nccnrdance w�ith Ihe ndes nnd tegui:�� <br /> tianc u(The lVater U�panmxn4 fur pmpmes and lixlures stated belnw. <br /> Durinq lhe timN ihat any n;the �v:ner mains map be �aken up by rensnn of <br /> anp imprnvements awlmrized 6c ihe Citp of Itvercu.in or of any sircel or ulley iv � <br /> a•hich lhry ro�v Lavr bren h�id, lhe Cil>'will nut bc rcquired to lurnish water during ..u' '��i Ilmii ' <br /> the prn�;rr;s n(such improvemenls tn any consumur u�hum supply may thus be cut <br /> n(f,ur bc ;iablc for nny a'am�Kes(ur its i:iilm�n sn t��do. <br /> APplicaliun Na._':._"J` '__"_"'_ <br /> lilock ._. � � ' <br /> ,�NS -- _��n� — — Zl-_,�z..nad---- ----� - - — <br /> _._\o...__.___��-.�..�.._L .Strml <br /> � _'-' <br /> __...... _. <br /> ___ . ._._...-. <br /> _.._. ..___ .____"_"_____ <br /> � - /� _.'__"' <br /> 'fhew�orktobecz�cutedby____ �{/��/ ,_..______ Plumber . <br /> . Statc sizr u(tap. �-_-'-�� � <br /> r <br /> --y✓--Tap to be in�tj�;;��;y, <br /> -_--------Natcrc(lnYE( �'�'���,�-, �\4 <br /> .i'/�/�/� j i\` . `\ ,p <br /> i """��_��dt�l � y J... ` <br /> l ( \I v' <br /> U:ma►�r',1'i Ir • ? ✓,( / � <br /> �� _9 ' , -' �' Plam piuCtt�riside I� L� �`.� Y <br /> 41, � � - '- -. S��e��IkM��licr " , � :i U, J <br /> � �' t � V <br /> '_ �-Hose b�b r�utsid` ' --� , !�� �0 •� �..Y _ti-; I <br /> � �"'Z.�• . -"". Hose Uib forbqilding purposes� ��� '� �� y� �I <br /> � -' _ ' Hosc bib uisidc� �� J,��',� <br /> ' I I <br /> q�' � � '-"" ' I3iUforstablecnmuning.__' _ rill � ��,� r(� <br /> ..__.__"Numbero(personsinfamily �_._ .. • ._.�.��.�' � �U� ) � �• � <br /> 1 <br /> --�'_"Numbcr n( rnoms in building . ��, /1 Pn� •'` I' <br /> "Phe premisrs are to be used as a..._.._ �' '" ' <br /> � � — \�`E'. � � <br /> Thc owner o(thc premises is .T�.�T1'___ � - ,i"', <br /> _ <br /> �`'�'``'`' �`'� J <br /> � ._ ____ '', ��'�.. . <br /> Thc a�;enl is .'______ � ``-__�� <br /> This :�pplicaliun.allho'�qh eigncd. shail not bc binding upni� U�e CitY� until ao �� <br /> �� -. cep�ed by The Superi�ucnde f c n1{r)I� anmrn� <br /> , .��`�` ��� <br /> ,..�i . ��.�� <br /> � rri��,�,� <br /> .I�;. "' � - � <br /> - �,;��� <br /> � i,_- _ . <br /> „`t� s�{':,,• /� <br />