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�`.-'`"`i 4—`f—3�—1l"_ �`�zl S — i�i.. — <br /> � w.�.r�:m a_�ruo—s.r.ca.—c-:c-za ' <br /> City of Evei�Ftt�Water Department <br /> APPLICATION FOR WATER <br /> Al! blmiks must Ue filled in or crossed out <br /> /�/ <br /> Evcrett.......................!�i�....��.f..%,�J......��........192.�0 <br /> f0 TfIE 5UPERINTBNDENT OR TI{P l�'ATPR DEPAI2TDt�NT: . <br /> CITY OB' E�'T?P,t]TT: <br /> I hereUy� apply for the use of �cater iu accord;uu•n n�ith the rules �nd regu- <br /> lations of the �Vat.r Departmm�t, for purposes :md fix'ures scat�d belew. <br /> Dnring Lhc lime thnt any of the w:der ciains mny be twkun up Ly rcason <br /> of any improvements authorized b} Lhe City of Gvcrett, in or of a»y xtreet or <br /> nllcy in mhich they may ha�e Uecn laid, the City will not Uc required to furnish <br /> water during the progres� of such improvements to nny cunsumc•r wliose sunply <br /> m:�y tLus bc cut off, or Ue liablc for nny- d:�mag�a for its tuilure s� to do. <br /> Application No_.... _ '�' ��' <br /> 3 1 ' — a'fl`I <br /> . <br /> Blocic .._�..�-�.�� � ./�:��� ... �� . . .. p..... Ad .. ' . ��_ . -......... <br /> No........�,3.�1v..._�,7%l�..I�..�.. 'r�tc���f.....Strcet ' , <br /> . _. ................................ ......._....�..//............_..... <br /> � . .. . ...... <br /> The work to be es�cuted by......__...._ �`lumber <br /> ..... ................ <br /> _ . <br /> _.._.__.... ..._. <br /> SfAC�' FIZC OI tIIjl. �Z /.S-GG . <br /> -.�/�-:....Tnp to be inserted in the mr.in. <br /> ......�........Nnter clonet / . <br /> .._..L.......B.ch G/ . <br /> f ' <br /> __...-......Urinal �' <br /> ......Z.....Plain tnucet insidc <br /> ......_�.._.Side walk washer . <br /> �-_.y!........IIusc hib outside <br /> ....�.........Hosr }ib for building purposcs <br /> .._..—..._fIo:e biL insidc <br /> ..._-.......Bib for stable con!nining........._._......stalL.._........_.._. <br /> ..._"' ./.....Number of persons in family <br /> ��..�?...-...Number of raoms in bi.iiaing 7 <br /> The premises arc to be used as�...��,1..�J.•._...... .. <br /> . . _ . ............. .... ��... <br /> The owner of the premises is... ..CrYLL(%GLyt.,r� ��j��� <br /> Thcagent is........._.............--......._.....___..................._._...... <br /> ........................................ <br /> This npplication, although signed, ahnll not bc binding upon Lhc City, until <br /> �;cepted by the Superintendent of the Nnter Dapnrtment. <br /> Signed.... .. ..........----......................._.___.._.._........_....................Applicar,t <br /> ecepted......................................192...... B <br /> .......................... <br /> r� �� . .. ........ ....... <br /> 7y -/t/3v �� - Su r' endent <br /> �i ;/' <br /> ✓ <br /> i � <br />