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- _ �: <br /> 0.'. �. Fonn 4 1°OJ 3-;-17 C.1�. . . <br /> Cf�'V OF EVERCTT==V1'ater Department <br /> � Ap�licatioai #"�r �%Vater <br /> All blanks must hc filled in or cru;sed m'.l � <br /> --— <br /> a `1---- - isi � - <br /> Evcrei[�-___'__._'__'_______'_ _ _ <br /> 'PO 'PIIE SUPGCIN7'BNDGN"I'M"CHP NATER DECAR7'?AIiNT, <br /> CI'fY OF I YL'RET7': <br /> 1 hereby apP�Y �'�� ��'� '�`e o(mater in :iccordann: �vith the ru�es and regula� <br /> timu��f The N�tu lleparlmenk (or purpuses and fixtares stated bclow. <br /> During [he time tha[an}' of Ihe water mains meq•br taken up bY reason of <br /> :my iinprovements authnrized bv the Ciiy of G��eretl.in or of anY strcet ��r �illr)' in <br /> �vhich theY �"'y !��ve been laid. the Ciey will nut bc required to(urnish water durin� <br /> the PrnGresa of sudi improvemen[s tu anc rnnsumer wLose supply nmy thus he cut <br /> n(f, or he IiaMe for any d/amqagess�fnr it? taiWre so lu do. <br /> Ap�::irntiunNo._.__b__L.�7-S-- ___ � <br /> tii���k ._'7-� �-- — !.�,�_..Z-- y-- - —,�a��u.�E.���,�� <br /> Na.._J -Z-�S�--�4�t-r�--_Strect � <br /> '_'_. .._'_-"'____ ' _'__"_'___'_.__"_ <br /> __'_________'_'__________.'__'__ <br /> 'fhe �vnrk [o hc exacuted by_-__--'-����-���--- Plumber <br /> State sizc of tnp. �� � <br /> __��_'_'_Tap to 6c inserted in the maiu. � n 4 ; � <br /> U <br /> �____N'aterduset -�ar .� �..1- P� <br /> .I3aUt � � r� ,C�j ��i <br /> .� �� � . <br /> - u���„i ,,,`'�� * � . <br /> _____.___Plain Caucct inside �4w'7 :-�� \'11\�/� �: <br /> 7 1 1� <br /> __Side walk w.�sher ! `' � � <br /> --- U ,a�°�� <br /> � , . <br /> ����� _'_._Ilosc bib outside � � � �✓ �1 �� � `.� <br /> (71 " '_._ Hosc bib (orbuilding pi ns '� <br /> � �' �� T ,� <br /> Ho=c bib inside � ��� :'. <br /> _____'___ ;�.�.�..-=���" . <br /> � � ___'_'___[3ibfcrs:ablcconraining__ __=�.:-'-��GCIL:.'�;.�— <br /> .'���-�' <br /> ._._-_____iJnmhcrof Persuns in family. <br /> ___�_____'Numb�ro(mamsinbuilding /� /) <br /> 'Phc Premises arc to bc uscd as a_-__. ..`-:c�1.65.�..l-4t�-_'-_.-_. . .-- '_..-. <br /> 7'hc uwner o([he premises is ___'._..._'____'_.--____-. . ._ _- -. . <br /> "l'hea4en[ is . __" "_-______"""_'___"""'__ <br /> 7'his apPlication, althouFh signed. �hall nut Uc bindinq upun [he CitY� ��ntil :.o <br /> mpted by �Che Superintendf�nt o(!he AY�ter D�parlmenL <br /> . Si�ned! J('� ^ �n�""u'-�`-�-� ��' '-(/,��. ApPlicnnt <br /> Accepiee�. - �: -.. .19� n �f,Y1LU-�=�2.���i.�..�.<n� � �f <br /> � ���(i <br /> /: ' �S\ <br /> _1 <br />