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-- . ._. � . .,. �.�-..�, ,- , , _ <br />w. u. ro�o,a -i,�u—e.r.co.—weu.za <br />City of E•aei�ett�Water Dc:pai�tment <br />APPLICAI'ION FOR WATER <br />All blruks must Ue filled in or crossed out <br />. �verett ......................._...�../......_............_.........192�. <br />'CO 1'IIG SUI'ERINTG�'PICN'P OF THP WA1'1?R DGPAItTilIi•:N7': <br />CITI OP P•.VERPsTT: <br />I 1�ereLy anply for the use of �vutm• in necordance tcith ihe rnles :md regu- <br />latimis of thc Natcr Depv�tment, for purposes nnd fis`ures stuLed hclow. <br />lluring thc timc th.�t nny of t�ic w:der mains may Ue tal:en up Dy rcasmi <br />ot nny �mprovements auH�.m•ized Uy ihe City o[ P•.vcrett, in m• of any streuC or <br />alley in whirh Ihey may un�•e Ueen laid, thc City �aill not bc required to furnish <br />tv�itm� diu'ing tUc progress of suc�h imnrovemrnts to nny ennsumer ��•hosc supP�Y <br />may thus be cut off, or 6c liable tor any dumuges for its fnilure so to do. <br />. � <br />Applicalion Nu.. _/......... % / Z <br />53 .............__ �- <br />Bio�k ) � .� iot .'��: naa... - <br />_ .. . <br />_ . .. ...._ .. .: .......... <br />No.. � <br />. ��. � .. . ..CIYt ti ..__ _ . . ._......Strect <br />._._...__...._..__......._.. ..._ ................................_...._..... ._....__........__. .......................:............. <br />The wrn�k to be executed by........ ___._._.. .__.. __._ ._._ ............_......Plmnber <br />Siate si;.c of taP• ��j �� � <br />... ��?.�_Tap to bc inserted in the main, �: <br />........_`.....���nter closet �., ri! <br />......_�.....11r.th � .. .. ,... <br />._�:.......Urinu] � <br />.._..:1:_... Plttin fnuc�t insidc <br />_.......-._.SiJc wa14. ��•nshcr <br />..... f ....._Hosn bil• u.ttr..ic <br />.......-......IIosc biU :or building purposrs <br />._.... .._...iIose bib inside <br />._..:....._._Bib for staUlc coulaining...._._..........stnll......_....._..... <br />.....�.:.{._....Number oI persons in family <br />-. y.....NmnUer of rooms in build� �g <br />Thc premises are to be use3 ns . ��)..,.....i '. <br />'he owncr of th�� preeiises is � . L�d �2��k� V <br />., ngent is._ ........................... /. . . _.................._.............P.................Y'......_.. <br />/""'"'". _.... <br />+�PPlicatim�, nithough signed, aliall not be hin�ing u on the Cit until <br />� 6y the Superintendent of eAVi�te�jEjinrtmon <br />,c- C 1�'" <br />Signed.��.........r::V..........._.��....... _ ._ ....................Applicant <br />�� � l <br />.pted ...... ........� .. "..19? .. Bv �. � .......................... <br />� � � v`lJ � j Superintendent <br />