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. . � M 'c'-.�z-�' 7 -- r z -z-G -�' <br />,:.n.r�,.�,a-mao-.a.i:��.�. c:r,.zi . . <br />City of Lvere;t�--Water D���ai�tment <br />APPLICATION FOR WATER <br />_111 ULmL's n:ust he filled in or crossed out <br />r���,�u ...................__......�/....� t".....................is� .. <br />YO fIIE SUI'ERINTGNDF.NT OR Tllb: AC,1TF.R DEI'AIET\fEVT: <br />CITY OR liVP•.RSTT; <br />I imreh}• npply for the uv,� o( ���;��er in accordance �vith the rtd��s nnd mgu- <br />lutions oC thc Nater Depariment, for pwposes nnd fixlures slnted Lclon•. <br />During the time thnt any of the a�nter mxins mny 6e laken up Lp rcnann <br />of cny imprnvcroeuta nuqim�iud Uy thc City o[ Ecerett, in or of nm� strcet or <br />ulle}' i� a�hirh ihep map hr.re been lnid, thc Cily tvill not bc rcquired to furnish <br />wnte� duriug the progress of such impro��emcnte to :.ny consumer whose supply <br />mny thus Uc cut ofi, or be liable for nng dam:�ges Cor its fnilure so lo do. <br />Applicntion No..........._ �-' <br />_. S.l .............._ �, s 8 s <br />61od. ....... .___. Add.....__. .. <br />.02.0? �l. (,Q� ........_ _._..__... <br />N°' , . CC--Qiltic-t� .......Street <br />....._ ___..__......_..........___....._......_ ................_._..._....__..........._ .._....._.......................... <br />1'hc �ra�k to bc executed by....__._......_. ...L� .-_.. ___..._...Plumber <br />State size af tap. , <br />.� � u <br />�...........Tnp lo Le i» scrted in thc main, • ' � a <br />....�........._\Vxtrr claset �� [�- � , <br />.........._....DaNi � � <br />!i <br />- :..::......:...Urinal � , . <br />� <br />_L.......Plain faucet insidc �. � ` <br />-�....—.Sidc o•all: t^.n�licr <br />.�... Ho<c bib outside 3 2 I� <br />_ ',�1 �( , <br />...............Hosc Lib for bvilding pm�pascs � . <br />__.'..—:.:�Hose biL insido �� � � <br />.......—..-.Bib for :tnble containing.....__..........stnll .................... <br />...._y...I�umbcr af persons in family <br />_..9...._ A*umUer of rooms m buildin�,�4 /-��_� � <br />The piemises arc to Lc used = n,. A�-��-- <br />. . ......._ __.. <br />The owner ot thc premises i�!c�.��!p 2L._ <br />. _ _ _ ...... <br />The ngent is........_ .....................��. _...... � <br />._ ............... <br />Tl�is <br />�ccepted <br />Aecepted......l...-. �.��.'..�..........19�.. <br />... _ ..................... _......................... _ . <br />bc binding uPon the City, until <br />