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�; n-�-, c-. 3 °- <br />0.< C Fcrm � I500 J-1- V C. P. <br />CITV OF EVCRCTT==Water Depart�ent <br />t�lpplic�tion f4r RJVater <br />:111 blanks must h�• filled in or �-ns,`d �i�l <br />Evercll..-_-' __'_'�_/z'_- __'_'--_19�-' <br />7'O THIi SUPIiRIN7'ENDGN'f Of ' 111: �VATC•.R DEPART\1EN'f, <br />(�I" )' OF BVGRC7'T: <br />I here6y applY (��r the usc o( water in accordance ���ith the rules and regula- <br />ti��nn nf'Che \Vater DeP�rtment. (or purpnses and fisturesstated Lclo�c. <br />During the time that :my ��i the wa[er mains may be f:iAen up by reason of <br />any inturnvements aulhnrized by �he City of lverclt. iu or n( ang s�rect nr nIIcS' in <br />whi.:h theY ����1' h.iv¢ been laid, thc Cih� will nut he required to furnish x•ater durinp <br />the Prn7�ress of such improvcments tr� any consun�er tchose supply cnp lLus be cut <br />nd. or 6c liablc for anY d:�m��pcs for its failum so to do. <br />Applirntiun Nu.._� 7'�_�""'_'"" <br />lilock _'. Lot.'_'_'- \dd. . _. -._.-__..-." <br />___'__'__' <br />Nn.. ��. _Q_�-�a.w1�i '�•_ __' _.. Streel <br />._.-.'---.._-.._.__ . ___________________"____.__'_.'_____.______._'__. <br />-----„ Plumber <br />"fhe work to be esecuted by_"_'___'__ '_ __"-"__'___'-._ <br />State siz�• �d iap. � 0 0. <br />__/�_"Cap to be inserted in the main. � � � <br />__ .f.___Naierdoset <br />_____�_ .Ifath <br />. _ . ... _ llcirul <br />___ �.._1'lain f:wcct insidc <br />. . _ - - _ _ - Sidc-ual!�..,.mc�— <br />. __...�'_Ifnsc Lib aa�side \ <br />_ ---'---11n:v�il�luclwikliuu-�u+cW"_i- � � / <br />�' .. __�Hus..7dh'iIISttic '. <br />. _13i6(nrs(ab��ypillnitung�----�z�'+}--- - f � <br />_ ._--.Numbcr u( Persnns in family . . <br />� �_Number u( raoms in bui!ding . <br />_ ___ <br />; �._� � <br />'i hc premises are tu bc used as a_ f �---� <br />__ _ ' _ <br />Tttc n�,vncr o( the Prcm ises is _ _ � � - . _. -' . . ' - . ' _ - _ _ � . -' _ " _' _ <br />__ <br />� <br />'fhc agcnl is ___. _ . _ '_. _""'_ - " ' " _. ... "'"'_' _ _"-_"_ <br />hi•: npplici[ian, :dt oi i t st ��iot r b� ding pnn the Citp, until ac- <br />� 1' % <br />� ,..uVrrime/��lit' .��/A� i�i <br />i ��I <br />cep�cd _'_"_""_' <br />%/2-� <br />I'_ ._�' ' '.' ___ ______"__Applicant J <br />� <br />i <br />�r(`' JT _. / _ ________.- J <br />--:5,,:.,��,����„ <br />