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� W. D rcrn 4 I SCO J-I- V C. F. . �.. • � <br />CbTV 0� EVERETT==�'Vater liepa►•tment <br />.t��plica�i�Ya fc�� Watex <br />Ali blanks' musj hc filled in `,r crassed ��u� <br />Gverett.-�i�"�� `'�/�.._.______1>Y�!._-- <br />L , /-' " <br />7'.) 'Piil. �UPI?RIN'I'IZ�ICIiN"f OG THE NATGR DBPARTD11iNT, <br />�'�� �� r_ y17. �%+,l� crrr or rvetz:: �•�r: <br />I herebY �FP�Y '�,r ihe use o( wa[er in ;u'cordance with the rules and regula- <br />�i:;n: u( "Che �Vater D�I;:�r[m�en�.. (or P��rpnses and fixtures s[ated bdow. <br />Durin�; the timc tha[ any of tha water mains may he tal:en up by reason o� <br />;wv imprnvrmrnLs au[liorized bp tiiu City of livorett, iu ur o( any strcM or nlley in <br />�vnich ti�ey m:�V have beeu IaiA. the Cily ��'ill uot be rei�uireJ to IUlO�SII 1VilIC1 dw�ing <br />tne pro�ress of sucli �mprovemen[s tn nny consumer ���hose suppl>' mal' thus be cut <br />o'i, i�r bc li.iblc (ur any damaR�es for its Jailurc �� to do. <br />Appliartinn No."_""� ;/--�-.�'�--"' <br />/ . <br />si����: _- --� "�-3--._�o�_.�� :-.'. �? _,�aa_�� -- — <br />�-�� �,r� — <br />N,�._.C'o^'.'..`_r"-`-- _��2__'.__'___'_ ._._....Street <br />/- <br />`_' _"'_"' <br />"_'__' <br />' ____"'_.'-' _'. _...� _ ____""_'_ <br />...-�'1'he wark to be executed bY-----�-" -- ' - - -..-------'- �'lumber <br />s� �� ��r czv. • <br />�.. y_'_ Pap t:, he inscrled in tLe mmn. <br />____ �__,tV:ucrcloset <br />-- --i -,�:,��, <br />__-..._ .Jrinal_-._ <br />_____'%G?lain f.wcetinsidc <br />.. _ . _' _ _' _:iide-�ca�I��easitc r <br />_ _ . _.� _ _ Hose bi6 nulside <br />. ___'. __. Hosc bib (or bui'dirtgpv�puses <br />. _ _ ______: Hnsrbib�insidc <br />_ _ _ _' _ "_ _ Bi6 for slablc con[aining _ . _ .. <br />___'.��_ Number of persons in family <br />___ ___ __. _ Vnmbcr n( rnoms in building <br />"Phc premises are to Le used . s a_. ... <br />��/ <br />'I'hcowncru(thep`emisesis___'_'_. _ <br />, :� �.• . �� ,r� . <br />` <br />.� � � ' ��C <br />�� 1.,= Y I <br />___..stall.______.._ �� <br />I <br />,_l� <br />� <br />/ <br />.�i _ �..�`��c._�-.-----�----� <br />Theagen[is..__.___-_.._ ___'._______"__._'._'.__.__'__._'__.'_" <br />This :;pDiication. altho:igh aigned. shall nnt bu binriing upon lh Ci�l'. unlil ae� <br />:apted by'fhe Superimendent a( the 1V:iter llepa,nent. <br />Sif;ned _ 2'�,yi-�!D.L. _�.GS.:KL�. '__'._'._._ pplieanl <br />�,��� _. / ', <br />A��n�Ptcd=.'!_.%-/'_-__.�'7 li)'-�-. /-�__'__.. .'_'_ . <br />/ �y s,;e�im��.a-�.� __ <br />