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. ��cct.. . - �� ` � . ._ _._ a - � . . , . . . , <br /> 1Y.U.Fomi 1-IGo0--F..I'.Co.-�-26-.� � _ <br /> City of Ecerett�t�Tater Departm.^nt <br /> �PI�LICATION FOR �I"�TER <br /> All li.:���:;l;s must Lc filled in or crosscd out <br /> ✓ <br /> / <br /> f <br /> l�:ecr<tt......................................_........�.� ..�.�......_19�...5... <br /> 1'0 'i'll?i SUPI'sRINTL.\UI?\T OR TIIE R'ATPR U�PARThi�N'P: <br /> CITY OR EVLRBTT: <br /> ' I Lmeby nlip!y for ihe use uC ��vater in ncenrd�nee teith the rulrs aud regu- <br /> latiuns of the �Vaf:r Depr.rtment, fur pm�poses and fis!m•es stated Lcl,u•, <br /> Durmg thc :imc ihnt any of thc water :u,�ins may Ue talcen up by rcnsmi <br /> of any improvmnents nvthori::ed by the City oi Et•crc6t, in m• of nny struct or <br /> ullep in �rhich tliey may haac hecn laid, the City ��•i1l not Uc rc�uired to furnisli <br /> . mater dm�in, the progress of such iiup�ovementc to nny consumer �vliose SuPP�Y <br /> m:iy tLus bc cuC uif, or bc liaUlc for :iny� damagcs for its fnilure so to do. <br /> Applicaytion Na............_.......__................ <br /> Block.._..�C...'�a..:.....Q.. Lot_..............r..................._.. Add........._.. __.......____..___.. <br /> No_...../.r50..�.._..oZ-,_..........__....... ... .............Street <br /> ..__ ._ _.._.__... . . .. .... ..._ ___... .� ........... ...... <br /> 1h� �vm�l; to be execu�ed by__��-��-a-•'�t--p __ . Q� � � � � � <br /> . . . ...�'-`-'_�:PI m� <br /> State sizc of tnp. <br /> ., <br /> .�-.?.-.......TaP to be inscrted in thc m:�.in. f �,`� � <br /> I...-.-....—\Vatcr closet \ <br /> J � <br /> ................Bath � �'� / <br /> ....-'.-..—L-Frinal ^� I/A L rj � <br /> ci O <br /> ..._�.,—.Plain taua.t inside �"'bA %� <br /> .--.---:Side walk �t'ashcr y I���V ] C9 <br /> . ...... J �.)_�J <br /> -�`..:Hose Uib ouCside ���� CF EVEiiciT Y/,'�icF, G�:''j <br /> _.—..—.-I�osc bib for building Purposes�................. ...._........ ....... <br /> .......... <br /> ..:.-...—Flosc bib insidc � � l � <br /> —_-. <br /> ................Bib for stuLlc containing....................slall.................._. <br /> ...—..-.:IQmnber of persons in fnmily <br /> ...o�.....Tumbcr of rooms in building • <br /> The premises aic to bc used as n......�t_.9-���---cQ-Q��� � <br /> ._... . ........ ......... . _7" <br /> _ <br /> _ .............__.. <br /> 1'iic owner of the preeiises is........_�a-P-4,U, S- q���_� � � <br /> . ..... ._.. ........ ........._.._ ..... _.".,.."_ ,_„� <br /> . �e a;ent is........_..................................................................._...._................................ � <br /> � ' is application, although signed;shall not b. oinding upon tUc City, � <br /> ���"I '� Up the Superint�"x1c/nt+ of tl�e W �tcr, Df partment. ^ <br /> �3i�nedGC�.�C�.�x�.__�./... �...�� o �,�L<.t _,.�PPlicnnt <br /> / ✓ , _._... .' . . � <br /> 1 - /�=- _ � j,... ...... <br /> ��.../��F�......_.....1J3.�. By._� ..L6fjy�....................... <br /> _..7;r-Superiatendent <br /> r <br />