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� z-{-c�. F �-� - - �-(� — YI - c...� � ,_ , . ._ ., - - � , . <br />A <br />W. b. Fcrm 1 ISGO J-1-1] C. P. <br />CI � Y OF EVERE'i'1'==��b'ater �epartment <br />�.�plication fo�r Water <br />A!I I:lanks must be 9(,pI�ic�d in or crossQc�y �wt} � <br />Gccrr� 4. _�����cvt-�c-i%✓ _ M"�_ _--_ . _ 19Y/_ _. _ _ <br />TO TI-IE SUPIiRINTEiJUI?N7' OF'PHL•' NATER UEPAR7'DItiN'1', <br />CI"f'i iiRli!@RE'PT: <br />1 herei�y npplY' f��r Ihu u,e oe water in accordance with ILe rulc, :wJ ref;ula� <br />tinn; uf 7'he Nater lleParun.rat, fm purposes and fixtures stated belo�a�. <br />During [he limc ih:�t any o[ the watrr m.�ins ma; be t:�ken up 6y rrason of <br />any imprnvements authnrizcd bc U��• City of Lvcret[, in or n( any strcet nr allc}' in <br />which [hry mal' have been laid. the Citp will nn[ Ue rrquired to furnish watcr duri�g <br />[he pm�ress of such improvements tn any consumer whose supply mn}• thus be cut <br />o(i. or be Iiahle tor an�y Jdam:i�;es for/�'ts failure sr to du. <br />Applicntion No.-J__�-.! '_!___--"- <br />� .� <br />Iilnck.___ ____LoL_/'�''�"'_'____"Add"'.... <br />--=j- - -----------� <br />vo._._.j.� 3 y_ �ai/T�f�o _ Stre�•t <br />----- ---- -- -�- <br />--- -- ------- -- ��-�-�1 � --���� �-'- - -- ---- --------- <br />7'he wor4 [n be executrd by _ . _". _' _ _ __" ' . _ _ __ _. _' _ _ _ _ _ _ _ __ ___ Plumher <br />Statc/s) ze nt tap. <br />! -- <br />�CaP to be inseRed in the maio. <br />'"""'/"'�yalCf CluSet <br />----f---I3ath <br />.__.___ .11rinal <br />. _ _'_ _ . _Plain faucet inside <br />. .__.____Sidc a�alk �easher <br />_ _ . . _Hnse bib uutsdc <br />_ _ __Flosc Lib (ur Luildin}; pur��uses <br />�U (/ <br />/C��_,_ <br />------Hos� n�� ���s�a� <br />__"' '11ib�orstablcconlaiuing ...._.___stall_ <br />__ ' _'Number of penuns in fnmily <br />____`� 'Numberufrm�msin6uilding <br />The premises arc In bc used as a_.. _ .'. __ __ _. <br />The owner of the premisrs is _____.�� • +. <br />'Che a6cnt is . --_ .. _--' ---- ------ -------- ' - <br />"fhis applica.ion. ailhough signrd. shall not bc bindin� upon Ihc City, until ac <br />cep[ed bY The Sc�-.�, i:uendent � jt(r. �Vnter Uepernucnt. <br />��>_, �� ,�%, 1; <br />Signed-_.Y _�;;<.. -:�_!_�_+�._/_�7_J1bf��_Appli nnt <br />AccePted. � ��_ _l�Y/ �2�'i� <br />- .-'____'_'__-_"_'_'_'__ <br />�_� ' snr�rintendem �� <br />