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� <br />w. n. F�,�» � isoo a-i-n c. P. <br />CITY OF EVER�TT==Water Department <br />Application for Water <br />:111 blauks must be filled in nr crossed nut <br />S <br />Erentt,_ _ _ _ _ � <br />._______�_ .__�_�._._.__-1�__--. <br />'PU TI�fE SUPIiRIN'PGNUIi�'P OR 9'lIG WA9'GR UEPAI27'\11:N'1'. <br />Cl7'Y l�P Ii7IiRG7'T: <br />1 hereby apply fnr �he use n( �vnter in arcurdance e�ith thc rules and reRula� <br />tion; u( "1'he Water 1):p:vtm •nt. tur purpo;c; and fiMures stated bclmv. <br />Unrin,n, thc [inic ihat any oi Ihr w:�r.r mains ,nay be taken uP by rensnn o( <br />:mc impruvements autliurixed Ly Ihr C�ip o( Gt•erclt. in af n( anY strcet nr nlley in <br />which thec may havc becn laid. tho Cit.' a�ill not be rcqnired to (urnish �vater Auring <br />the prnFress �d such improvements tn :i.ip consumer �ehnse suppW may �hus be cut <br />n(f. or be liable tor anp damn�;(r'�r/ (nr i�s `ailure so to Jo. <br />APplicnt ion N� .' ___ J�- D b. _Q , �� <br />Hlock . gs S_ _' ._.Lot/�- Y� �U--� �-� _Add_.�n._Ul-_/. <br />;•,�._35.L.9_ _��-�--�� _ Qlu��:.sv��� <br />__�� <br />-- - _ --- --- - - --- � /q--,�-p---�- ,�-� �-=- �-�- ----- -- <br />'1'hc ���arl: lo he esecuted by. �_ :D__L ..,V.9`.�'..`�_-4r4�>c_ Plumber <br />St:�tc si:c af taP. � <br />l� <br />!.L _e__Tap tu be inserteJ in ihe main. � a <br />_ <br />�._._N:�rercloset // ,�—� `e-''--� <br />�__.Ilath � <br />.__. " _ .Urinal � . _ <br />.__"____Pl:�in (aucet insiJc <br />. __'_'___Sidc �calk �cashcr � <br />_ _"_'._Huyc bibuulsidc <br />.._'_'-__.Ilosc bib tnr building pwpnscs <br />.__.__.__Hosc bi6 insidc <br />Bibfurstableconlninin�;._..___. .__slall.___ � <br />. �_!._ , <br />____ ____.Numbcrof persuns in (amily � _� � . <br />.1�_."'Numbcr nf runmy in building . . . <br />"1'hupremisesaretoLeusrJasa__ . _.____'____.'.".' "_'_...__. <br />7'hra�rnero(thepremisesis ___...______ <br />_ _... _'. _"_""""'_ _""". _ __. <br />Thc aFent is . ___'__.__.._. _.._'_________' <br />.__.._.'____'__"..___'_______ <br />This applicalinr�, although siGned, shall nnt bc bmdin� upnn thc City. until ao <br />:��oted by'1'he Superimendent uf t e 115rter Deparlment. <br />XSiRned��U�=.'.LL11CC1?L<.-._.___ ____'._____Applicant <br />Aneptcd.. _ _. 19Ya 6c_C=ie'� <br />�— / • a.� - ----- -- — --- <br />�-- _,. ���������., <br />