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- J� <br /> ,_...^ <br /> (� �_ -'� �—'- ✓ <br /> � �J ^4 J l�l—�� <br /> (. !v'- ,_,c'•' '• -� � Tap No...._-� -- ...�......... <br /> . .-� <br /> �� ���'��-�� � 112UKILT�O ���AT�R DISTkICT <br /> -� SNOi10\IIS?I COli�''Pl, �PASfII\�GTGA' � !� <br /> � S <br /> ;% ��PPLICATIO '� FOR WATER <br /> ' _ ,ail L1snLs must 6c filled in or crosscd out <br /> . . —��\i Je <br /> `,�� <br /> . �:.. \IvkilCr.o� «'ushin�,nnn� ............_-.._..................................... t9S........ <br /> T'(1 'CIII: SU7'liRl?v`99:K1)liI�T OIP THF. MUIiIL'fL''U N'tITL�'R D1:iTRfCT: <br /> 1 Lm'e6}' applc Cor the use o: �cn[c in aceor�i.mce with thc rules and reRu- <br /> la6ions� of thc Alu}:iJtco �i'ntcr Distric!. <br /> � Um�i�i;; Lhc time lhut :��c oC thc �c:dcr mains may hc tal;un u�� l��y musnn <br /> . ot ;,ny improvr.menta :mLho-ized bp the ilistrict in or ot :.m� struet, road or <br /> �� alle}• in �vhich the�� may have been laid. the DisLrict �cill not Lr� iequired to <br /> . furnish �':ater dm�iu� the preFress oi such improvements to :inp ronsomer u'i�ose <br /> . suppl�' m.:p thus br cu: off, or 6c liable for nny d:�mn�c for its failure sn tu do. <br /> � 9pplieati�:� No...._.._:...................................... . <br /> ' ^ r�/ . �,p / ; <br /> ' BIacL........................................ Lot...........��.. ......_._. Add....c.__._..::_.........._'�.�.-. <br /> �' \�o.........__................_....._j_....�....`�7::: "-- -� ..._Strect .' ... <br /> .......�.�.................... ..... .............. .__... <br /> � `��.Os...-........�.�-'�-�...IL.t�� ....A-.[.�...�....,_............... _ <br /> � <br /> _ ..._._. .. _... . ._. <br /> , _. . . � , , <br /> _.... _ - - - <br /> ?' .st��t,. � <br /> scai� s� � or c�: ..._:....:_.-...... <br />� "'� ,; _ y <br /> $...._._�J.�..... . ......has becn rcceived witii this applicn�ion. <br /> \ _.. <br /> � ..................................... .'..... ...........7._...._......_ __...._' <br /> �p _.7 r Sie �cri�:icrtd:,��:. <br /> f <br /> � '1'i�: Premises are tn �c used as a......................_..............................'......__.............. <br /> I Th= o��•ncr of the premises is......................._......_...................--.............._............ �. <br />�I �. Th: x�ent is...................__......................_............_._.._.............................................._.. <br />� T'ris applicntion, •ilthnuy�L si�,rned, sh�il not Le bindir�g upon thu DistricL <br /> . �m�il ;.ceepted by the SuPerinten:_nc of the ➢ful;ilteo Ai':iterDistrict. <br /> � Sifined.........................._........_............. _..........................._.......Otuucr. , <br /> Iip..............._..........................._..........................................il pcar t. <br /> Acropted................._..............................._1!14........ llc.......................................................... � <br /> S14]If,T1AlLf.1l(�tl)lf i <br />