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�.NTO.3-3"/ry �, <br />i _ <br />t:'�0.Fuc.1 !SCOYI-i'IGP. a��t1��l.fll <br />CITV OF CVERCTT==Water Dep <br />AJpplicatiorn f�r Wa���r <br />:111 blanks must bc filled in or cr��sse� "��t <br />-- '' ..__191._____ <br />3l- .� ___. <br />Eaeret[. -_ --._- __'___ <br />'f0'fHE SUPGRINTED�UI?NT OF'I'HL NATER UIiPARTMENT. <br />CI"1'1' OF �`lI:RE"I'T: <br />1 hereoY �+PD�Y fur dre use oi �vater in accordance ��'ith �lie rules and reF��la- <br />�iui; nf Duri `g�Uie time that nny of1ihe�va[er'mains,na} bcateken'uP 6y reason o( <br />:: ic imProvcmr.nts authurize<I by [he City uf li��erett. in nr o( any ::Irect ur alle}� in <br />h may Ihus Uc cut <br />�.��lii�h theY �»:D' h�ve been laid thc CitS' ��'ill nut bc rcquired to lurnish ���alcr durin{; <br />nii, or 6e Iia61c fur'anYia ni'�;"' for its (ailur Ssu�to d��l�"hc 4u�r.' <br />. ____ <br />ppplicn[iun Nu.'__"'""'" "-_'__ Ad�i.. <br />_ <br />/� ._._Lut._ �-�__"_'_"' __ _ . ._....... <br />111nck..'/�`�.7�O..�i.. '— �L�A'`_�__..Strect <br />\u..__.. _'� '_ <br />___'_.' <br />""_"'__.. _. <br />."__"__"'""'""""_""'_"_""_""___'""' <br />._...___._._ <br />-�----- �� __._' Ylumbcr <br />'fhe work [o hc exe:uted by.___'" --�� � - <br />Slale sizc ��( taP. <br />_�!1-__. Cap [n be tnsrrted in thc main. - -:. <br />_'_ �_"_. Nater dusct . �'i � � � . . <br />___�__.__Bath � � � ���1,1 . <br />..._ .Urinal � .1;.��'.\ ,� . . <br />.___ - �..ni��s <br />Ylain fauret inside �. Q 1(34 " <br />_ ___.__. ..`�1: Cl . <br />__Side walk �vasiicr <br />._____...Ilnse bib uu[side `.��-�_' ... <br />_..__.-..Ilose 6ib (orbuilding purpnses ' , . .-_'__Y.. � .; . <br />__•- <br />-, _____llusc bib insidc �.. " ' . <br />.. .st:�il -" <br />_'____'_Bib(�rslaUlecontaining------�-- - <br />_. _ . . _ _._\umber uf Pcrsons in f:unil�. <br />___�__.NumUcr ��[ rooms in buildinti <br />___'_"' <br />_' <br />"Che Preroises are to >e usee as .--- <br />_' _ <br />"_'__ ' <br />__'_'_'____ <br />'__' _'___- <br />Thr o�cner of Ihe Prenuses '"".. <br />'Phc.Keniis._.___.___.__.__.___'_____._____ _____________... __. <br />. ____ <br />7'his applicatiun. allLouph signed, shall not bc bindinq �ip�,:� Uie CitY, until ao <br />.�•ned 65''rhe SuPerintendent o �h�-e. sNnter UeP:��iment. _)� <br />/ �[-'_J._�-i✓(�/-�/._`_ta"'.l--.___ PPlicint <br />Si�;ned - - / � <br />��,( " _ <br />:\iceptcd ._.�__.-'_ _1!� I1).��/%7'�1�_. __-d,n,.i:u.ii.r.� <br />/ � � V <br />