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I <br /> II <br /> 1 <br /> I <br /> I <br /> _ �„.y a_y_ y..— � <br /> , n� r-`�l7 .�-JP� H(. <br /> .... � . _ � � <br /> 0.'. D. Pcrm� I500 3-I-1]C.P. <br /> CITY OF EVERETI'==Water Department <br /> 4 AppliGation for Water <br /> All blanks must bc filled in or crocsed t <br /> I?ccrelt. _ /�'.�.�(..-�_ ___..__.lyv._.�� <br /> TO THE tiUPERINI'CNUEN7'OY' HE NA1'GR UGPAR7'Tf1iNT. <br /> '1 'OF F:9ERETT: <br /> I hereby apply (or lhc u. nt waler in aemrdance with the rvles and regula� <br /> ti�ms ut Thc Watcr U:partnunt, for p��rpos?s and fixtures statcd bclnw. <br /> Uuring the time�hat any�n( Ihe watcr mains niny br takrn up by rcas�n of <br /> :my improvements authnrized bv thc Cilc u( C��crclt.in or nf any strert or alley in <br /> which they may h:rvc been laid, Lhc lity K•ill not Lc rcquired tu furmsh waMr durinF <br />-' ihe progress o(such imprwements [n anY�:nnswnrr w�hose supply may ihua be cut <br /> o((.ar bc liablc for any,Aa/m�:i,R��s5(ur iw G�ilure sn to do. <br /> Appl ication Nu.._`"�.`�_�_.___ <br /> i <br /> u Rhrc -. b'L� Ln _.(��/.�_:/S.c/�•Add__'__' <br /> . _"'__. ___ <br /> '1 �.a�,3_�n,��/ <br /> ' Vn...__. _._ . __'__...__..Stmcl <br /> _.__" . __.__. ' <br /> �'��,fhe�cnrkinl�ecxecutcdby_-_-..___.____ '-_ ....._..____-.._' Plumber <br /> Sute sim��f tap. ��— 'l,/.,,._i���- <br /> r/ //ica�q <br /> � _�__'Cnp tn be inscrted in the main. <br /> ,�J _ v a- <br /> " " __N'aterduset �' % �✓ ���/// ��' ��, <br /> ..Oath �' i � /^� <br /> -- " Urinal � 0 <br /> _..Ylain (aucet inside � � <br /> ':___.__'_Sidew�alk�casher O �y�� <br /> � '_____.._Hosebibnutsidc <br /> ""_____-Hose Uib fnr building purpoxs <br /> '__"'___.Nnse bib inside <br /> """__.Ribforstableconu�ining.._____-__stall._.'__ • . <br /> � ___'_____'Numberofpersnnsinfamily, <br /> �' <br /> _.______Numlxrnfrnumsinbuilding ' <br /> . The Premises arc tn be used as a____.____'_.._'_._'.'.._'.'__""""' "_'"' <br /> The owner of ihe premisce is -.. . f I , r ` t ' ___'_."""""- <br /> ' -__ '_.__'__'_ _ <br /> ' _"__'_ <br /> ` � <br /> 7'he aHent is : . - �. :. , ' <br /> .""'_"""' '_'"____'_'__'_ "___' :"`_�""_ '_'___"_" <br /> I'hiv apPlication,nithough signed,shall not bc binding upun the Cily, until ac <br /> � �cptcd by The Superimendent�d ihe 1Vnter Uep tmfn�_ <br /> Signed___......���-�..�- .-�'__"'Applican� <br /> �, Acccpted__�'-��'_.___19�Z Hy��."___"`_'_""_' <br /> Superinlendenl <br /> i <br /> EI <br /> 1 <br />� <br />