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....,..,.,�, < iscn a-i-i�c.a. � � � . . <br />°�f'��' �F EI'ERCTT==1Vater Departme��t <br />�.�,��ication for Wa�e� <br />:\II blanl<s must bt filled in or crus;cd oul <br />liverett..__. __'._L.�—'— � <br />�f�) 7'IIC SUPI?RIY'1'IiNUliN7' Of 7'FIE WA'PF,R UIiP:1R'P\iGI�'I', .191 %��/ <br />CI'I'Y UP Ii`/IiRE7'T: <br />1 I�em6y ;�p��ly fnr the nse uf �cater in :iccordance �cith tlie rules :utd regula- <br />ti:m.; „f 'Chr IVa[cr llep;vhn •nt. Cor pmposes tmd :iztures stated belu�v. <br />an�� imf> ovenents�authori,:ed�Lp t'nr�Cil}�uf I:c nett� in��ir�u( �:my�strrct�nr allcy in <br />��'hich they ;naY hav� 6t�en laid. ti�e Cit�� will not ue rrquired to furnish �cater �du�i � <br />ihr uru�ress of such impmvem^nts tn nnc consuwer �vho=i. .�uI��P�y m,^,p thus be cut <br />��ii, or be liahlc (or any danrr,.cs fnr it. Liilure so tn du. <br />:1pplicntion Nn._' '.%_ �j> <br />J -�./__'7�___' <br />I;�rcl:._."_ ' <br />_-__ ...._�nt___'_ ___Add...__. <br />_____.' <br />_ <br />X,... . .. .�Q—_ .____ '. <br />-. �- -._ _/�_���_".'___..Strce[ <br />.__'.___'__ . .._____.- _-__..____..._ <br />7'he �rurk tn 6e executed by._._. -________________ <br />-_.____'__ _.__._ .__' Plumber <br />tit:�� sizr of tap. . _ -- <br />✓ , � ('_'� <br />- y-Tap to bc insertca in thc main. —=-�/ <br />--- �__4Vntcr ciase[ <br />---�__. BaW <br />. . -.. _ .l6�inal <br />---_ Plain (aucet insidc <br />-'--"_Side t�'alk washer <br />. --__._Huse bih nulside r.� � <br />-. ----__Ilusc bi6 fnrhuilding purpnses <br />---__Hnsc bib inside <br />.________Bib for sta6le conlaining._.___.__._.stall__._ <br />_ . <br />- -_ --_'_Numbcr nf per.�nns in family. <br />- -�fi <br />---'_Numbcr ul ronms in buildinq <br />7'he premises are to be uxd as a <br />- -._ .__.____.___.__ <br />_ '______ <br />ie owner o( the pnrntises is _____. -'-'-. <br />.._______...___.. <br />____ <br />'Phr aCen[is ___. ..-_._--_�.-_--_ <br />' '_'_'.__ _'_"_"_'_""'_ <br />"fhi, :ipplicitinn. althnuFh silmed, shal: ro[ be binding upnn the City, until ac- <br />��=pt��il Lr 7'hu Superinicndent f he �V.� er De irin,cu�. <br />Siyne�i ..� � ' , 1 <br />A�r�.��ti,l ������ 4pplirant <br />-�.—J,:._. .�7 I; �'��� ..��r,____ <br />! ri <br />