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.- � . / .v ��u •.�.— -.. <br />W. D. Form 1 I500 (�-:-I; C. P. <br />CITY OF E1 ERETTe=Water Department <br />Application fvr Water ' <br />All bL• must- � filled in nr cr . ^ed nut1 <br />� C� �t /2 � � <br />F.verett....--'_�'_ '____""""'_.._"''_____191."__ <br />9'(1 'PHF'. SUPGRINTE\UIiN"C OF"fBE WATER DEPAR7'TiGNT, <br />l'1'1'l' OP G!'L•'RE7'T: <br />1 hereby npply (nr the use nt wa[cr in accordance aith the rules and regula- <br />Iions n( 7'he 1Vater U:p�rrtm�_nt, (or purposcs and fistures stateJ below�. <br />During the [ime tf�at anc n( the m•ater mains may be taLen up by rcason of <br />:my imurovemen[s authorized by the Ci�e ot Evcreit. in m� o( any sirec� nr aliey in <br />�rhich tlieY may 6ave becn I:�iJ. the Cit}• e•ill not be requircd tu (urnish water during <br />�hr. pmFress nt such improvements tn anr rnnsumer �r;mse supply may Ihus 6e cut <br />otf. n. bc !iable fur any dam;�gcs (yr�s L�ilnre sn to do. <br />�� �� <br />AppliCn�iun .'_ <br />_'____. __ <br />"'_'_ <br />� (/ � • <br />ui���k � -`� . 7�Loc--- �11� -----�-� �da - --------- --- <br />\o.___ ._ %��_� �!�'� �S:C_�� .Strecl <br />�__ <br />.--____-_._..._.._ . _._______..___.__'___________________________"__".. <br />The�cnrkinbec�ecutrdbv ""__'__"_"'_'_'____"'___'_'_" Plumbei <br />Statc/����fffzr n( tnp. <br />/�l�� _7'np ln 6e inser ed iu the main. � �-dt7 <br />�' <br />" _ _ _ �' _ lV: :cr closet � <br />. __' __�_.I{alh <br />--.. ---- .Urinnl <br />._.'____Plain faucetinside <br />_.__""Side walk was:ier <br />.___.__.._Hose bib outsiJc <br />_ __'__ _. _.Hosc bib tnr building purpuscs <br />. __ _. _ ____Husc bib insidc <br />�� <br />__"__._._13ibfnrsla6lecnntaining._ _____ . st:i .i' „' ""- T 'y <br />__ __ / _.Number of persons in family 1 C '„�y;.��.��! <br />..__ L__'Num6cr o( ruams in 6uilding .�, �� �;>� <br />� �T <br />'I'hc premises arc Iu be used as a-._________._.__'._..-'_..____._.__ <br />'I'hemvnerufthcpremiscsis _____'______._.__ _ ......._..._______. <br />ThraCentis ___._." __________________' <br />'fhis applicatinn. although signed, shall n��t bc bindin�; unun thc Cilp. �mtil ao <br />cepted by 1'he Superinlendncnt ai Ihe Nnter Ucpar�ment. <br />SiRncA . `17��: `L1i' _� [j' S.'l.l,� . .. �;�� `Z. S _ l..a� i FPlicnnt <br />� .- <br />Actepled5�.—�2... IAFt� By.�L`.�-- <br />, ___-_____"svr•ri�i.n:e•,. - <br />.� /, ,/� . . .' il .. <br />