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Fi.iFl i�_'--- .�. /-.. r�'TJ; r,.i/%'._ . <br />l i/. <br />W. D. Form 4 I500 J-i-17 G. P. - <br />CSTY OF CVE�CTI'==Water i�epartment <br />1��aplication for �afer <br />All blanks mus[ bc filled in or crossed ant <br />Gveratt,. __"______________ �/__.�__'_J3�_ � <br />TO 7'H� SUI'fiRIN7'ENUEN"P OF'1'II!? W:.7'GR UF,PARTn7ENT, <br />CI7'Y �'�P B`/ERGTT: <br />I hereby applY fnr the use of water in :iecordence widi the rules :ind regul:r <br />tiun, uf 'Phe'N:�c�� t���;��un ��,�. t„r n�mos�ti :�„a r.c�.���s s�,��d �nio��. <br />DurinF [he time that any of Ihe v:;iter mains map be taken up by reason nf <br />:mv imornvemen[s authurized by the City of GverMt, in or nf :uty stree[ �r alley in <br />which Niey may hnve been laid, thc City witl �ot be requircd [o (m'ni�h watcr durin{� <br />���� P��Fress of such impmvemen;s rn any consumer whose suppiy may tl:us he c:�[ <br />nff. or bc 1ia51e (or any damages for its faih�re so to do. <br />Applicn[innNo`.'__""_�' "'___'__' �7 <br />Rlock _'L.�.4_�_ __'_ oL'_'�� �� D_ _'- Add'-__'._'_'_"__'_ <br />;r��..._3.�b.3-2_. �"�'-�'�.sc���c <br />. , ,,, <br />-.v�. v _ <br />- ------ - ----- — - ------ --------- ----- ----- <br />'_"7ne wnrk to be execulyd by__'_"_ <br />___ _ _..eSrs�___._ Vlumber <br />��'yta/tc sizc uf tap. <br />'� /.� --Tap to Ue inserted in the main. 1 CG __ "_, <br />� �� i � <br />.__�'_.___Na[er doscl � <br />___�____.Ba[h �. <br />__ _' .Urinal <br />___. ~_Ylain (�ucet insidc <br />_ ________Sidc walk washcr <br />_____��Huse bib uuL•;idc ,/ <br />_' ___Hose bib forbuilding pwpus�.s �`1� 1 � . <br />__ '_Hoscbihinside ,. � <br />_—.___Bib (nr sta6le condiininq._ _ ___ __ _ _stall._'_ "'_'_ <br />__ _____Num6er of perwns in family <br />� _e�e_'_'_Numbcr o( roums in building . <br />'Phe prrmises are :a he uscd as a _ ___. _ - . -- ------- ----- <br />Theownero(thep:einisasis _____. _..�:.-I- .�f_.11T�__f�_�.._L________. <br />"fhe aRentls .'__'____ __________________ ___�_" .__.____"__--______....___ <br />fhis apDlicx[ion. although siqned, shall nnt 6c binding upon [he Citv, until ac <br />: by The Superin�enden[ o( [h Vnter )eparlmen <br />Signed__._�i_-. ;—:-`'i r�i-'--- plitant <br />___ <br />i�} Accepted__'_ __'____"1�J1 Ry" ' ' �LY!/��' `j'.�___"' " <br />�.*�,¢'�12,� / � --N�Su;.�rinteniier.i <br />,:1:'�W.. � � R <br />