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=�-��+-3e-ae_�r �.��r ,-�k 3e . � <br />R'. U. porm !—.Io00—£..LCo.—G :4-27 <br />City of F.verettr--�jJatei� Departinei:t <br />APPLICATION FOFC �ATER <br />All Ulanks must bc tillcd iu or eros^ed out <br />liverett�...._ .............. � - / � ..... <br />........._ _ ...................._...................1� <br />1'0 TIIP SUP�RI1'Pti\i1PN1' OR 7�;IR R'ATEP. Pl'sPAP.1'niENT: <br />CITY OI�' i•:VG1:�TT: <br />I hcrchy ��pP�Y for thc usc oC water �n ::c.ord:mee wi[h Lhe :cles n�d regu- <br />laliuns of ti�c Wan�. Depmlmenl, for purpos�s �md Cis�m�es stal�d bclew. <br />Dm�ing Ui�� tlmc thaL ar.y of thr water mni�s mny bc lnl:en up by rensan <br />ol nn)• iuipron.. ��.t:, nnihori;:ed L}• Lh�� City of 4:ccret[, in or nC nny utreet or <br />uiley in which !hcy� tnnp hnve Ucen ln:d, th� City will noc 6c required to furnish <br />�cater dm•ing the progmsa o[ sudi im, rot•c�v�:nts to nay cnnsumer whose rupply <br />m:�y� thus Le cnt� n.f, orcj1�c li»blc for a�iy c.amag��a for iis tnilure so to do. <br />ApPlication No.__. .!..�...j�...�._.........�/ �7% . <br />i <br />I31ock............_...._..�...._. ... Lot.._�..%._._.__. .......___. Add........_ .._.__. ....__.... <br />Ya......?.3. ���._.. . _ _ . .. _..........._ str��c <br />___....._ .... ..... ........._ . _...._.__. ........._. _ _ .._ ..._._.... .__ __...._.........__ _..._..... <br />Ti:c �vorL• to be executed bg....�'-°L1�'C-'°`'�-�--�- -.��-p�umLer <br />Stntc size of lnp. / � � <br />�_��.....1'np to Le inerted in thc mnin. �� '� —� <br />._(...........R'atcr closet <br />..�............Bnth . ,' ;� i <br />................Urinul � � `1 �,,`� <br />.�.. ......Plnin f.r,:cet incide � (�, �. � ',1 �� <br />w �-t:t �1 ` <br />�- Side teall: n�ashcr �� ✓;(� n. h�,C .;'�� <br />..`�..... 1�, ��� r � q '7 <br />._............Hose Lib outoidc !.; ft,..-, v .'., . <br />. <br />.�_ •...... .;;,j r � :. -. � . <br />.__...........I-Iasc bib tor building purposes •.,.,,, ' .�� • � �. <br />. '• : - <br />.....'......_Hoe.e Uih insidc . � s �- �..` <br />' �`�...� �� r <br />�-...I3iU for staLle contnining....... _......... stall .................. •�,� <br />................I�umber of per�ons in familp � <br />..�..........Numbcr of raoms in building • <br />The premisrs nrc to bc vsed ns ____��!-.'.--cC..._ .............. <br />Thc owner ot the premises is..`�...I...c.._. .. _ .... .............. ....__..._.. <br />ThengenL is........._........_ ................._............. ...._................._............_�..........�....... <br />"his npplication, alUiou;h �i�iiul: :;h. l not bc Uinding upon Uie City, until <br />pted by ihc Superinl id�9it ufJlLc '\\'�/tcr vi1"j�nrtment. <br />Signed...... .. _�:.... /....1l./..:../��"�-�-��.:.t"1 ...................A lic it <br />/ yi <br />�;: ceptcd .:/ ...._192...... i, B3/J .,/ J <br />......__ . ..._ . fj . .. ... <br />_ _ ................. . . . ... .. <br />�/-- : � .�o e% • _ � ndent <br />