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� .: _ . -/- �-_ , ;r . � � � � <br /> 6'.D.i'orm d—l'uao—E.P.Co:-6.zs-2a <br /> Ci .�� of �.verett•—�ater Department <br /> Art�LICAT�ON F�R ����'-�g� <br /> . Ali Ulr.nl:s must Le filled in or crossed out <br /> L:ccrett.............._�/�`/�G.fi:/�...._�......__.19?/... <br /> TO TI(E SUPI:P.INT1:NllCNCITY OF �V�l ETT PLpA''1`1'J�C. � <br /> I hcrcUy upP�Y for tl�e use of water in nccc::lance �vith the ruics and regu- . <br /> Intimis of the �Ya[er Depnrtmeut, for PuiP��ses nnd tistm=s fit1t�� U���`'reason � �� <br /> llurir.g lhc tLne that nny of the �anter mnins mny be taken uP <br /> ullc;nin�wli hL�haytmaythnve�b�ecnylaicl, he C Y,�vill not�he�ci�uiredyto�fueni h ' <br /> �cater during the progress ut �uch imP�'ovements to any con:.umer whose supply <br /> ❑u,p �hus be cut off, or be liaUle for un damnCes for its &�ilure so to do. <br /> ��s�r=� -s'S,�' , � <br /> Applicatiun Nu._.... .../.......................... . . Add_�,�ts�-�...�...._.:.:::.:.�, .,� � <br /> . i, <br /> Block.................�.................... Lat............... . <br /> ...... <br /> ._._... ... . ' <br /> � <br /> — � Strcet <br /> No ���' �/_... . . ca.. . .....:.. .. . � <br /> , � ...... ..... ........... <br /> ............. . . ...�� /' �- <br /> . ..._. _. ".. <br /> /' .��P�� Plumbra 'j�l <br /> The «'�rk to be execntcd bY..,. S"G <�C� � . <br /> �� /._ <br /> Statc size c° tap. / � <br /> ..f�'✓:�.]'aP to Uc inserted in the main. j i <br /> � : <br /> _..,�..__....R'ntcr closet �� <br /> . .�.......... <br /> Buth <br /> / <br /> ...:.-�.........Urinal c <br /> ..._�:._....Piain faucet inside , <br /> ......--__Side walk «�:�shcr ��i <br /> .._.1..........IIosc bi� outside � + <br /> ...:.-:......Hose Uib for Uuilding PUrposes <br /> .......:........Hosc hib inside � <br /> ....__........Bib for sL�Ule concnining...................stnll..........._....... <br /> .._�........Number of persore.; in family <br /> � . <br /> ..�-........Numi�ec of rooms m build:ng � <br /> �--�...:.......................�.................. <br /> 'Lhe Premises nrc to b� used as a.... .... .... <.. <br /> ...__......... .......�.. <br /> ............. <br /> The owner o£ the �remises is......._.... ..._.__.....__.__ .... . <br /> ......................:�:............ <br /> ThceGent is..................._--...........--.....................__............... •.. <br /> Ti�is aPVlic+itiov, nithongL• signeu, shall �ut be Uinding apon tne City;Until <br /> accepted by fhe S'�:Perintendcnt � tli^. Nnt��eynrtm t• <br /> �y1 `^ 'y� �� <br /> SiBned._l../.{�?a.�.�A...l.(1�._/./.�a...0'.{'li?!�'...� ...,f..........ApPl:csnt <br /> � i�z...... r;,...� ... .. ............. <br /> ...... <br /> Accepted.:-.�...-�r..��-� �� ' � � '`' ��Superintendent <br /> � <br /> I <br /> .... _- - - ---- - - - n���� <br />