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tcc Gn , _'e . �r <br />N'. D. I'nrm 1—IG00—} n.Co.-67�6.R1 ' - <br />City o£ F,verett--�Jater Depai•tinent <br />APPLICATION FOR WATER <br />All Llanks must be filied in or crossed ou� <br />F,vcrett..........._........ _.�� ...................................1'J'�`...... <br />TO TIIE SUPliRINTGNDli1T OR TIIE R'ATIiR UEPAI:T\iCRT: <br />CITY OR IVF.P.ETT: <br />I hereLy n�iplg for the use aC tvaler in nrcard:mce ��'ith the rules and regu- <br />lations oC thc \\'atet Uepartment, Lor pm'pnccs and fi#ure;. sL•tted Lclo�v. <br />During Uic time thnt any ot thc ��•�ter mnins may be lnken up Ly teason <br />of nny improcemenls nuUiorized Uy the ('iiy of I'scerelt, in or of xny st.rcet or <br />ulle}• in which they may hnce 6ecn la�d, tLc City will nat b.^, tequired to furnish <br />waler during the progress of such in�prnrements lo any coneumer a�hose supplS <br />map thue bc cut ofC, or beq liabl/e for any dmnnFes for its fnilure so to do. <br />Aiiplicntion No......_.._�D_ /. G...S....... — `�'Vc �% % . <br />1 ...._ Add/ : , . r � _L)l1 .. . •'' r <br />llleck..........'T:�?..�j........_.. Lot_..3 �._._.__......_ .__..- ._.. _,. <br />� <br />No.._..__..r2i��0..�%.._. ��......._Btrect � . <br />...._..__ ........ . ..... _.__..... %�� ��� �........ /........... .. ._....... <br />'ilic �vork lo be e�ecuted by. ����C ..._.. t er <br />Sl e sizc of tnp. `�� <br />.��:_�� Tnp to be inserted in the mnin. , �. <br />....�...........R'ntcr closet /Z I S . _� <br />...�............ ll n t h <br />................ Urin al <br />.._��.......Plain faucct iusidc <br />..._—.�.._Sidc «�nik �rnshcr <br />�...��....._Hosc hib outsidc <br />.l .—.-._Iiose bib tor building purposes _- � <br />- IIose biU inside . � <br />_.._ .. Bib for slublc mntniuin� ...................stall................_� . <br />._......Number a[ persons in family <br />.�� ..NumUcr of rooms in buildin��� <br />I nc Premises nre to be used as u..� _. 'n� . <-G�-�./�.�-�! ._ --... <br />Thr a�cner nf lhe ptemises �s ....tl.-..�, .A.L.C-�..-Y-/'-_- .--.... <br />TI� agent is....._ .....................__._......._........._........__....._....................................._.... <br />nppliration, ulthough siqned, afintl not be binding upon the City, until <br />Uy thc Superintendcnt oj-the \Vnter D pnriment. <br />� C! 1 <br />sig,ed..k�:�...r11-e..... .. ;_...-:..._......._...........__ Plicnnt / <br />/ // r � _ � <br />t_.�ti -...l6.1.....-.......19 .?�.. Dy.__�L� .� ...�... � .. .. . / <br />/ S PCr7RfSIl_ c� <br />