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, ,:.. : , <br /> , <br /> ' W. �crm 4 I5:10 �-1-I'C.P. •• <br /> ClT1 �F CVERFTT==Water Department <br /> t�pp�icatic�n for `V�+�ater <br /> :111 blanks mus� b ffillid in or crossci� �f <br /> IiventL._ . - �/ / .-`�_�.19�""�"" <br /> � �___.'___-. ___ <br /> U� - - <br /> TO "Cl�lli SUPI:RI�J'1'ENIN?N'f O�'I'lIG �VATLR DEI:AItTML•'N"C. <br /> CCI'S'OF I3`JI:RG"1'T: <br /> I hereby apPly (ur the use.of water in :iccnrdance�cith the rules and regula- <br /> u.�::s uf Th�� Natcr U�parun•nt. (ur purposes and fizu�res statcd bclow. <br /> Durinu 8ie time thnt an}' of thr�wter mains may be t:iken up by reason of <br /> :mc imprncem^:�[s autl�orizr.d 6y thr Ci�r uf lverclt,ii nr uf any sVicel ur alle5 in <br /> wi�i::h theY �»:�S' havc hecn laid d�.e Cii�•«'il� nnt bc rrquired �o hvnisl� water dm�in,� <br /> th�•prn�ress nt�ucl:impmvrnenis to any cnasumer .chnsr srpplc m�rv [hus be cu! <br /> n!(,or bc liahle for anY ����».-^•�-; (�'�its (adure so tn do. <br />� APplic�tion No.__ _� �_.�'___ � <br /> b o� — r.�„_�---- ,�aa. — <br /> _ <br /> ism�F ..— I- -- <br /> �j ^-� ------- <br /> ��� D _. _�r-6 _' ____.__"..Strort <br /> .\'�,. - ------ -- " <br /> ---- —... _. .----- <br /> � ------'--------------- <br /> --------------- <br /> 'fhe �rorktnbeexecu[edbp -_.--'______ .-_--..._-- -- --- 1'lumber <br /> Scdc.ec af lap. � <br /> i <br /> 5/L•ip tu i�c inserte 1 in tl�e main. /.l C) ���� <br /> , f ' . <br /> .___'�___ACe�crdusrt ���. <br /> _.._�__. .I3ath <br /> I' in�il <br /> ._.. �. .- I'lain (aucut in;idr ` <br /> . _..____Sidc �calk n:asher � <br /> '"1{osc bi6 nutside � <br /> _ <br /> _ _Hose Uib (or uuildinS P��rpn�es � . <br /> _ .______Plose Uih ins�.ac <br /> _____._'_liib(urstableconc�ining.___.__... stall._ _. _. <br /> _._ �Num6cr of Persans in fnmily <br /> Numbcr n(rumns in buildinF: <br /> "!'hePremisesaretohcusenas ;i__. ................. .....___. __ --___. <br /> Theawnerofthepremisrsi:; _____. ._ -- --- ------ ---_-�. .-.-_ . <br /> Theagentis .__... _ .. __._.__.___._ ...-____--_-_ � <br /> 'Phis anplicatiun. althuugh signed. shall nut be�indini' ��P���� the GtY� mtil ac <br /> ccptcd by'fhe Superintenden[ of the Nnter Ue �� �� ' <br /> /� i I <br /> J� � <br /> $i{;rrri . ""' / .Y _���ll" '_.'_'_'Applit:urt <br /> _""_"" C <br /> __ <br /> / _ .� ./ <br /> lc:r,�ned r_�_.�:� :__. . .19Y-� R•:ii _"'__"_____" . _ . <br /> . � � ,_ � .� ___S�.r.cr�mcn:-m <br /> i <br /> i <br /> I <br /> . _.. . . " . . . . _ . �. _. _— _ — � <br />