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, � c:u'�.4 iir:S.% <br />CiTY 0[ `�'TT==Wad��• Department <br />���licatiar� for �����' <br />,111 b�ank=_ mu�t bc filled in ur crnssed ����� <br />�/� A _._ 191'�� �- <br />livcrell. . -. -_ -__"_ ' <br />'fU '� 11{? tiUPh:RISI'GtiUP::J C OP'PHE NA'PER Dtil'Ait"I'17fiN7'. <br />CI'fY OF L"/I?RG7'T: . <br />I herei>y :�pPly fo�. the use n( water in acenrdance wiUi the n�les anJ regi�!:�� <br />�:u ui The \Vater U�Dnrim�:nt, (ur purpnees and f:xtures stated hcluw. <br />.. During ihe time thn[ .inY ui the wnter nmins io or�of �;n )�strce����r�:Jle)' m <br />:mc intProvements �uthoriud bp U�c City u( lieorcll. <br />:: hicf. theY �nal' have been laid, lhr City ��'ill nul he requirrd to IurnuL ��:���•r dm inp <br />!hr pruy;:ess n( suCh imProvrntrnls Y� uny consuntef o�husc <uPplc mnv IFu. hc rul <br />� �ti, ��r he liablc (��r :mY �I�01''�`'s (or iL, f:iilivc su t�� �1�>. <br />�c7 �- -- <br />:1VDlirntinn No."__ ' ' <br />q _I.nL_._��- -�-�'._"_Adii . . . . <br />lil��cl: -��p--J-- � <br />\n __."_ <br />_`�.lj �2•. ..__'__�.�---�-`-�-L .___.Strect <br />._____"'_'___ <br />___ __""'-- <br />'_-_' <br />"" _""' <br />' _"_..'_'. _ _ <br />-- _ G�������Ti��_'__""--'__ Plumhcr <br />'I'hc «'��d< to he c�«utcd Lp.------ <br />St�/d/^ sizc �',f l�p. <br />// _%�_Tap to be insertcd in tlie n��i��. _ ' <br />� ��a:� �.. <br />'•�' <br />� _. _ _A14�tcr closcl -� <br />13ath ,�,,��'' ,+�::y�1J ��y �• <br />.Urinal �5'1Y'�1' ;f/I � <br />_ _. _.- .Plain (auml insidc �{ `� ���I1,..�: <br />. _____Sidc walk washc� ;�' •qy,�f �Q jRn, . <br />_ O .'� . <br />.___'_.'FluscUibuutside ��; �.,.. ... <br />_11ose bib (�r building Purpnses <br />.. ��- .Hosc bib insidc �. �'����,.- . <br />..��___I3ib(nrst:�blcc�ntaininR------�--stall.��-��,-�-r. . ' . <br />_ . _ _Numbcr af persuns in family <br />. ,,�., ..Numl�er n( rnom� in huilding <br />, '_'....._. <br />_ . <br />'fhe preinises are 1�� e use� �+. --.. <br />_ -' <br />'i'he owner u( the Premises is _-__ . <br />'fhc agent is. ----- -;n —� <br />'I'his :�PPliration. al! <br />,-,��nril bc "fh�� SuperiNc <br />:1r� ,tud � 'i`� � �/""' ."-� <br />^ �i�c �.' <br />.. . , �.-. - ... <br />/ , � <br />__._________________..._. <br />I�v. until ac. <br />___APP�icant <br />. .. . . . . . . � , . � . . . . . - . ' . ' Di" � . . _ . . �. � _ ' u . 1' .l <br />