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...„ , (/ o —�r — t y C. C ,�� � c . .,.:, l.> - r..� <br /> . � • <br /> W. �. Fann 1 I500 J-1-V C.P. <br /> CITY OF E1'ERCTI'==Water Departntent <br /> Application foa� '�Vater <br /> All blanks mus[be filled in or crossed nut <br /> � <br /> � tiverett.------- � <br /> _"'____'__b'_'-___.'_""__'_1�1�__._ <br /> 'PU 7'I1E SUPIiRIN1'I;till14N7'Of'1'IIE R':\'PER UGPARTn9tiNT, <br /> CI7'Y OI� G'11iRETT: <br /> I herr.bY apUh� fnr the use o(water in aecurdance with the rules and regula- <br /> ti�,nr u('1'he Water U_p'�rlm_nt. fur purpnscs and Gntures stated below. <br /> DurinK [he[ime that anp ui the water mains may be laken up by rea�on of <br /> any impruvemcnts auUwrized bp tiie City of livcrett.in ar o( any sVicet i�r alleY in <br /> �chich they m�1' h;�vc been laid, thc l'ity� will not bc required to lurnish���atcr durinF <br /> die procress o(such improvrments ta:my consmner �rhose Slt�)�IY IllBy IIlUS bL'CUl <br /> n(f.or bc liable (or auy dam:U;es(m� its L�ilur�� su to do. <br /> Applicntion No."l_�__ � / , <br /> Rlo�c/k ._ _/•.�Jy Lot__�____._.._'_Ad�rfs_��,�L�-�. <br /> . \0`.7_?a�rClv.a.�--`-`�µ--�_'__..____..Slreet <br /> .___._.___"_ ' '_"___'............. ' ' <br /> ��-�,fhe �curk tn be esecuted bY---------- ------------'--------' Plumber <br /> Statc vc u(tnp. <br /> / <br /> --- '�_'Cap to bc inser,�d in tLc main. <br /> :--- ___\�4�cercln<ct /�i �_ <br /> --.Bath � /�- <br /> '-- .Urinal .. <br /> ___�__.Plain (nucet insidc <br /> -__'�"_Sidc�calkn•nshcr '� '. . <br /> _ r <br /> ""' '._Ilusc bib oulsidc � <br /> ""' _Ilosc bib (or buildinF purpn<es <br /> ___ ____Hnscbibinside <br /> � � — <br /> ..'__'._"Uib(orstaUle contaiuing.______.-_.stall.__.____ <br /> '_.�7 _"Numbcr o(persons in (amily <br /> ..__-f"__Numberu(romnsinbuilding�t. <br /> 'Chepremisesarclohcusedasa_f_ ./�,�__...._.."_'____'___ _-__. <br /> The uwner o(thc pretnises is _"'_/-�-�-' ���---------- <br /> 4 <br /> Theagent is ."'______.'__. ___.'_______'__ '_...'_.____._""'..____'____"_ <br /> I This applic.rtion, altliough signed.sLall nut be bindinH upon [hc Cit3', nlil ao <br /> �eptcd by The Superinte,de}y�>(1�� „��r Depa� <br /> ��i . ��(�� � <br /> �� SiSned . 7-°�'--�" . _._-" ----------.Appivint <br /> : � Accepted�C'.__" "I�_`-. [3}'_'_�_�.._._.___ ..._____"__.. <br /> � r----•— � s.��.���,��e,��R- <br /> � � s- p , , , �.. <br />