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�,��_+ � ..-�..r _ i� . _ F_„-c'o(. o.: � ;4r.�. :-in( � .. , <br />�:'. i. Fac� t I500 d-1-17 G. P. � <br />C1TV OF FVE12[:T►==�✓ater Department <br />1�.pplication foa� VVa.er <br />:1i1 b�anl;s musl be fillcd in nr crusscd nu[ <br />fiverett�.___'._.__'_ __ _. _ _ ./_�%�--.____191ii±._ <br />"PU'fHE SUYIiRIN'CENUI±N'P O�'1'HB \VA'I iH UEPAR7'n]GN'I'. <br />CI'1'Y OP L'9I:f2ETT: <br />1 heru6p apply for the use uC wn[cr in acrnrdance with ihe rules and regula� <br />tinn; of 'Phe Water Deparlm;nt, fnr purposes and Oztures sWtcd below. <br />Durin� thc timc ihat :mp ui the water m:iins mny 6e tzken up by reason of <br />uny imnruvcinents �uthorieml by the City of liverett, in or o( any siree[ nr allep in <br />which they nml' h�ive becn laid. U�c City will not be requireJ tu furnish aa[er during <br />die prueress o( such impmvements [o anp consumer �choxe supplr ma}• thus be cut <br />nlf. or be liable (or any Id%mn:iges �i(or its (ailure so to do. <br />Appliartiun Nu.'_'_f__`_� CJ_ 3-_ �/I � <br />isi���: _-� � y - ���---�''�-'-�''3,,d�i�r�t�/64�'�I' <br />. � <br />-- - <br />—- <br />.,�.__�'�_O__ ------ ----`� - ----.s«e�� � <br />- --__---- ----- -- - --------- ------ ----- --- <br />7'heworktn6crsewled6r-________'____.._______"_"1`_5_:�_'Ylumber // <br />Sta� sizc uf [ap. �r,�w:j i� i�- ' �� • <br />�y_"Pap ta Ge i�scr[ed in the main. �EI I .� <br />,�:�� f� � � , , ,- <br />__________15'a[erduset . �' � t I. � <br />I � <br />___'_'.I3ath `1` liJs f , � <br />___..__ .Urinal �� 'I ' . <br />... 4, i�'i�� w � <br />.__._____Plninfaucctinsidc ` �.•, "_... � <br />t � ' ,,• <br />_ _ _______Sidc wall< �cashcr .• ' �-:�c� • . . <br />�..-.. -.,.. <br />__'-__"Hosebiboutside '� .. .. � <br />__"___Hose 6ib (orbuildinK Pw�poses <br />.-_""__Hose bib inside <br />._____"__Bib(orsuiblernn[aining.___...._..stalL.__. _.__ <br />Num6cr ot persons in Lnnity <br />.__-�-___Numhcr of rnnms ie ouilding <br />"1'he premises ;ira tn be used as a _ _ ___ _ __ _ _.___ __ ... _. _ . _ <br />..___.____ ..__. <br />7'hc u�encr u( [hc premis.s is _____. ________. _. __. <br />_.._____.____..______ <br />Thc aeentis .____.____._.____._'.______'__ '____'_ <br />_____'_"__ ____'______. <br />l'his applica[ion. al[hough sif:ned. shall uo[ be binding upon [hc City. until a�, <br />ceptcd by'fhe Superinlendrnt nf lhe {Vuter :n�tment. // <br />Siltned _ _ _� _ _ _-�y�/���{'v_ _ O. . • _ _ _ _ Applican [ � <br />Acccptedr9���.__._ .�j I3 <br />�.._. <br />— ' ' . _"___" <br />• �'-'s�.�rcrintendent'- <br />