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• ,- <br /> �-: �� ,,, ._ _��� � : � �:%�v.�� . <br /> �-�,___ I-� ?rG_ �; <br /> 15'.I>.Form J--IFaI.—F..P."o.—f�:6-24 <br /> City uf }.'.verett---Water Der�rtment <br /> APP_LICI-�'�ION F�I't WATER <br /> :111 Ulau!.:� must Ue fillcd in or crossed out <br /> � � <br /> I:ccrett,........../ ...�..Q..t:.-�.�.. .......................1�?...... <br /> Pn 'PS1E SUP�!2:V'11,i�Ui�.S'P OI�' TIIP: �'�TBR DEP�RTIi�N'C: <br /> CITY OR EVCP.liT^': <br /> T hm�ehy npnly for the use vt wnter in aceord�mee with the rules �nd re6u- <br /> IuLions of the 14at^_r DeFnr[ment, fm• �m�po-c: rmd fixtures stateQ belo�v. <br /> Dm�ing lhe time that any of the �c�ter mains mny Ue taker. uP liY rea;on <br /> oC any imprarements nu:horizad by tlie City' of I:cerett, in or nC nny strect ur <br /> :illcy� in which thcy may ha�•e been laid, thc Ci!y will not bc reyuired to fm�nisli <br /> v:ater dm•ing tLe progress uf such imyrovements to miy cansumer whose sup;dy <br /> m:�y tLus be cut o1C,(c�r/Lc liablc for ::ny L.unnges for its fuilure so to do. <br /> Applica:ion No..d�(...�_:S.l..._......... i�i i��l <br /> L'lodc.......................... .. . Lot_ ............. ._..__...._..._.._. Add__�1�nn�kilL�����. - <br /> � -_ __. .._ ........ <br /> , <br /> No._����.'1.L_.. __..G.�122- .:��[.G�r__......_.....Strcet <br /> ....._........_........._............................_................_................... ...._......._....__.._....................._... <br /> Thc work to be executed UY_. .... ..........._ .__.....__.... . ........._.._....Plumber <br /> �t:ite size of tnp. /;`y''r•�l���_. <br /> .���..1':ip to bc inserled in Ll�e main. <br /> 7 a <br /> _-_�......._ZCntcr clo. �t <br /> _./..._.....i3nth <br /> .__5.r.._._Urinal <br /> ...1........Plain fnucet insidc <br /> . �._.Side walk v:asher <br /> .__/........Hose bib outside <br /> .__L...Hose Uib for Uuil;ling purposcs <br /> __l..—......fiosc bib inside �� <br /> ....�:....Bib for stnble containing....................stnll.�................ <br /> .._�-.—.....Numbcr uf persons in family <br /> .._�...Number of rooms in building .�,/- _ <br /> The premises are to be used as a....__.._._�N�<G�c�-W(�«-����- <br /> The owner uf the premises is............................_...__.......... . ...... .... <br /> .............__... <br /> -:�he ng�ent is............................._��.�.....���_ _. . . ,. . ................. . <br /> apptication, nithough signed, shall not be binding upon the City, unt <br /> . _ U� ihe �uperintcnd/ent of the W cr D pnrhnent. <br /> �igne . ..... ./.r .1..�..J!���:~����%rs`_"��.......�....../1PPlicant <br /> � ..... � � <br /> ` � i-- <br /> .... :....-��._....-392� By... .. . �._.,�;..,- . �' . . . ............. <br /> f ` pecintendent <br /> ��.. <br /> -.... <br />