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. . '��J' � � � �� _ ' �. <br /> N'. D. Form a ISCO 3-bl]C.P. � � � ' <br /> " CI�fY 06 EVCRE'FT==',Vater Departr <br /> :,��,:,, <br /> Application for Wat�x• •����' <br /> All blank�must be fillyd in o assed uu[ <br /> livcrell.. __'_'_ ' "'-""'. �"'_'19f�_. <br /> TO THE SUPIiRIY7'ENDIif!"I'OP'PHE\YAT;R.�lEpAl2Tn1EN7', <br /> Cll'Y OP 1?Vf?RF.TT: <br /> 1 hcreby apply (nr tlre use ni water in : .:oNance with Om mles and regula� <br /> tinns n('fhe Nater U:parhn�nl, (or purpose� :m fixlures s�aled belme. <br /> UurinG tl�e time Ihat nny of lhe water� :iins rna��br laken up bY reason o( <br /> am� imprnvemenls authorizeJ by thc Cih� uf IiecrMl,in �tt n( nny strccl ar allep in <br /> �ahich theY maY 6ave bcen laid. thr Cit)'wi!I nut Lc required to furnish waler during <br /> the pro�,resc of auch improvemrnts tn:uiy cousumer �chose supply map�hus br cut <br /> uff,ar bc liable fnr:np cl:�n��;�or i�c 6iilurc.o tu da. <br /> Application No._.__�_" "'__"_" <br /> it�„�k - -- �-/.f- /� -��7 - <br /> � - - / -------- .�dd..-- - - - <br /> \o._.�G •3� '__..Strccl <br /> __" ' '_ '.._ __'__'_'1titi.. <br /> _ ._____ .._.__. ___.______'__.__'_"_____ . <br /> 'Phewnrkinbeexecuteel6p. _. _.__"_'_�_'__ ____.__'_." Plumbcr <br /> Stnte sizr o(tap. � y�r.o e <br /> � �� � _ �. <br /> -�".l'ap to bc inserled in Ihe main. <br /> --...__.__�1'atcrclusrt [ ' a� -7 au '�/GF ) �7 <br /> -_'_' _ Bath �l� .Gatn �d�'�,� Clet.(� . <br /> _ . . .Urinnl D <br /> �2 �,;, �,✓. ., ,� <br /> _._"'. Pl:�in (aucet inci;lr <br /> . ___'_"tiidc w�lk �casher <br /> .. _______11u=v bib nulside <br /> --"_____Ilusc bib far buildinK P��•r�,•rs <br /> .-..'_""Hnsc bib inside ` ` <br /> \ <br /> -_"'_""BibfnrsWblcCun�aining..____ . stall ��.Y <br /> _ .. <br /> --_---__Numborof prr�uns in tamil9 `, <br /> .-_""_"Number n(rooms in buildin� <br /> l�he premises are tu be used as a_ _ ._____.'__ ' " <br /> /J�, / "_" <br /> _'_""__'___' <br /> 'Phc awner of the premCis�es is^J/(�eGQ.�r�_[OT}.2.. qyfky�'Hy�„��C,.. <br /> Thr. aqent i. ._..._._.��GC..._.GCJ.G[�f 7- -EQ___ . <br /> J __"_". _.__'__'_ <br /> 9'his �ppliralion.although cignrd.shall nol bc bindin�upnq the Cit>', until ac <br /> �.al by The Superinicndem u!tlw l\'ntcr Ucparhnent. <br /> �( f� �,/ �, �j�� i <br /> � <br /> SiQned ___ .. (F-.`.�!_.._�l�CG-¢<lZt�i�L _/__:A�plicant � <br /> Accepir�i. � - . �.'_._ 1'3S7'l IS�'� <br /> _ - '/ , . .__'_ " <br /> _'_'_'_ <br /> .s,�r.��r�io,i�m <br /> t <br />