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t'nI<11 An, 1. <br />ALL BLANKS MUST BE FILLED IN <br />.OR CROSSED OUT. <br />:\ppliunLloti Nn..�D D. L . .T <br />1$verett,. �LI�J aC..................14g?00 <br />To 'I'll t:.SIf1'I3RINTrNDF.3T In' THE T.eansrr WATER COMPANY: <br />1 hereby apply for the aso of stater in accordance witb the ndes runt regulations of the 1sverett Water <br />Company, for (lie purposes and fixtures slatod below: <br />The work to be executed by ...................................................... P11Duber. <br />- If mTop Is required, Croy. Out.[t�' .....x ... Top to be inserted to the main. <br />............Water Closet.. ............Hose 1311L..for building parpo-r-. <br />r <br />............ llath - .... ............Nose 1311), Inside. <br />... ...... !I. Urinal - .... ... I........ 131b..for stable eoutaining.... .Stall.. <br />............Plain k'aucet Inside. ......I ..... No. Persons In family. <br />J Sidewalk Washer.. The premises to be used ny�j[ ........ ....... ........ .Y . <br />. ......... liose Bib..outhide. <br />Sign <br />