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E <br />� <br /> f <br /> G_ N'r`I�. L� IS'�5`�A,r <br /> �iY77�-:- �3- z a-c , � <br /> ^W.�.Form 4— `nu—E.P.Cu:—G�2G�2a <br /> City of ��verettrW�ater Department <br /> APPLIC�TI�N FOR �ATER <br /> pll bl;mks must Ue fill^d in or crocsed out <br /> — � � <br /> . ...........132.�.. <br /> ����u.�-..�.�............... <br /> liverett,_._�.- .�.... <br />� TO TAE :iUPERINTENllEN'1'. OR • «'ATER UEPARTBIENT: <br /> :- � ' OF EV�I2GTT: <br />(' I IroreUy npPly for�t e use ot �vat�T in xccordssnce «'�lh the rnles' nnd regu- <br /> Iutiuns of the Nntm� Denarhnent, Sor P�TPoses und fixtures stnted beiow. <br />� During the lime thnt any of th�1e°City ofIICverett, n orknf mi bsLreetsor <br /> of nnY »»Provements auL'norized by <br /> Y <br /> nlley in which ihcy may hsve bcen l:ud, the City will not bc required to furnis <br /> may thiir1Uc cv�t off,or Uc liablc'for nny damng�snfonits`�falurcrso`toS,o�PP�� <br /> n/�1 � <br /> Applicutinn No....25..¢'..i..::�-....`.... <br /> � �� Add.. . _.... <br />' ..... �t.�._.!..........._.._........ <br /> _........._.........._..__.. <br /> Block................................... ' <br />' �.a.�U.._......-.o`?-. .. ............................._:;t^ect <br /> No.. _ <br /> .............._..... <br /> .. ......_.................. ......._.................._..................... <br /> ..... ... . . . <br /> .. .. ____......PlumLer <br /> The ',vork to he e::ecuted by... . ..............' .�^C>__.__ . _. _ _ . <br /> S�n��te sizc of tnp. <br /> �'/ �� ' / <br /> ..;/,2...._'Pnp to Uc inscrted in tlie mnin. <br />� ..._[.........R'nter closet <br />. .._....�'- 13nth <br />�' ....--.:-:....Urinnl <br /> �........Plain faucet inxiP.: <br /> ._..��-....Side u•rilk ��':�+hcr <br /> ..�__.... ..._Hose bib oulside � <br /> .,,".....�.-.Hosc bib for building� PUrP�ses � <br /> ...,_-.:::_..Iiose bib inside <br />' .._'.-........Bib fur staLle containinG....._............stall_..._....._...... <br /> _,..`:.......Number of peTsons in fnmilY <br /> �lS'......Nu'.nber of rooms in bnildinR � , <br /> �...__ ..... <br /> q'1v: preinises nre to be used as a..� � � ,- <br /> .. ....__..........__.. <br /> . .. ...._ ...._....................... <br /> The o�en^r of the prer.iises :s.......�'����� - �� H� <br /> Thel �y the'S���perintendcnt of IIie�Nn�r Depnr!Inent...P...................y�..��J�... <br /> Th�� u i licatian, nithough signed, �hall not be bindin u on lhe Cit Until <br />� ,; x /+ <br /> i / ��-�� �� <br /> j . Si6ned.�.� �..,.....1..._1'L.''7iL1./,�'`' � Ap icnnt <br /> �u,.:. � ,_�.�.... <br />' � <br /> � _ _ ' - „�. ' B•... ... . . _.r�............................ <br /> ��.........�.�. 5 <br /> 1�������-�-�� �� , _...y—?Superintendent <br /> I <br />� <br /> �.r <br />