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Y.��o��-..'/ .i-� �..� . _ ,_, � c�IT'L� .-- '- . .. <br />4: . O. Form 1 I 500 �-�- I] C. P. � <br />C1TV OF CVCRETT==Wat�r Department <br />Ap►plicati�n f�� d�Vater <br />elll blanks n�cet hr fillen in ur cra>sed nut <br />IiYct'211. - -- _-__.."_'� ' '� �'__'."'1')I�j. _ <br />'I'U THE SUPIiRINTGND�NT OI� TIIIi �t'.\"CHR DGP.ARTMIi57'. <br />CIIY OF E`iIiRGTT: <br />I hrreby :�pply tur the use u,' water iu nccurdacce with the rules and reCula� <br />tinn+ �rf "Che R`a.cr llepartin:nt, ior nurpose= and !izV�res s::ucd 6elow. <br />Ducing thc time lhat any u( the �ra[er meine may be ta6en up by rcason o[ <br />anv inm�ovemenls authorieed i�p th�� Citc nf Eecmtl in n� o( anY s'Ircet u� allep fn <br />�chich lhey mry have heen I:�id, the City will nel 6e rcquired lo lurni� h�catrr dunn{� <br />Iho prnprecy uF such imVruvcmrnts tn :my rnnsnmer vrhu�e suppl., ntay Ihus be c�.n <br />��it. nr br linblc [ur :my rd7ama7;cs (nr its (ailuro xo r�� �{u. <br />ApplicnlinnNo./_'l� "-'�'_____ <br />Rluck -------(O-- ���O�o"t__/3'_��"/S-��\dJ.___.. <br />. ..'_"'_'__ '_ <br />\u. _ _ v.s..�.+_ � "/-7-�`—L�� _ _"_ _ _ _ _. Strce[ <br />rT' <br />._.....__.__._'_"' . ..'_""" _._ ._..._..._"__--__'__'_-__' _'__'_'__ <br />'I'he�rorklubeasecu[edbq_ '__'_"",_ "'_"'_'_""_'___'_'_' Plumber <br />Stale gi>.r n( tnp. /. �.�. �� Y— � <br />� w <br />.. _��_T:qi to be inserted in [he main. <br />. _ _. __ _�-Natcr closet �..J� _ .. <br />'____,_Iiath � <br />_... _.. .Urinal - <br />"' '__Plain faucc� insidc <br />....___Side walk washer <br />._. ___llusebi6o�cside ,� <br />___- 'Hose lab tor LuildinF: Durpusc�; <br />. ____.HoscbihinsiJc <br />____._.Ribforsc�blecontaining___.___ .=r,�ll____ <br />. ' . __Nuntbcru( persons in (amil>. <br />�'��. _ Numbcr nf rouma in 6uilding <br />'Ihrpn�inise<are[obcusednsa ..... .... ....'_'_' _._'__._. _._. "-" <br />'I'hr. owner uf [he premisrs is _' _... _ _' . _.... _ -_ _ _' _' _ _ _ _ .. _ _. .. '_' ____ <br />'Phcaqcu� is ._'_'___'.....'__._'__'_"'_ '_._._' ' '_'_""'..___"_"'_" <br />'I'his :q:Plir:dinn. allhough signed, shal: nol 6e binding �,�pnn Uie Cit1', �mlil �o <br />�plcd b}� 7'Iv� SuPrrimcnd�eynt n( tl�c 1Y�dcr Ue?ar�nienl. <br />, �i4�ied yCTl.2..4..._!_ �_-V'-r�f-U—ci[iRaf.an.�_'AnPlic t <br />dcrrnir,l .�� . __L31 13�' __. �" <br />, . _ _ _ ' _ . . .. i.��i..�..� . _ <br />