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`_„"•,u.,J.- � � --' : - i- j e+.� (. . �.�-.-�-�...�,v-t� � � - 1" . . _ . . . <br />l5'. IL Farm J--I69J—E.P.Cn.. -5 -d �S <br />City af 3�:��erett---Water Dep�1rtmeilt <br />APPi,IGATIC)I� FOR VJ1�-TE� <br />:11I hdaul;s mu>c be filfed :n or crossed nut � <br />ISvcre I t, ................�_(�._�c:....................._....19?�i.. <br />PO TH� �L'PElilA1'EI�UI:VT OP T;iP•, �t'A7'I:R DEPAI2TbIENT: <br />Cl'fY OP PVEI2ETT: <br />I hcreby a�ipip for the u�,c of wntcr in ;iccordancn. a•ith the ivles nnd regu- <br />lntions o[ N:e ��'ater Department, fcr pm�posea rmd fis:��res stated helo�v. <br />During Uic time thnt any of thc watcr mnins mny be luken up L7 rcason <br />oL :iny i!n�it'ovements 2uthut'izr_d by the City af Lvcrett, in or of nny sLrcet ��r <br />ulley in ;vhich thcy nuq� ha`•c Ucen ]nid, the City will not be required to furnieh <br />a•uter du:�ing thc progress uf such imprnvemei�ts to n�y ronsumer whosc su�plY <br />m:�y thus be cu: utf, ryor Uc ]iublc Sm� uny dxmr.ges for its :nilure so to do. <br />Appliention No.d..-J �...(.� "�� � - <br />.........--...... � : . <br />Blodc........� ................%. �_ I.ot.I._— . � . Add..; ,:' � . , . .: <br />. _.. _.._ . . ...... . .: .. <br />T o..�.l-.�.�..0...�.......,/..�i�........._....Street <br />..._._....._ .. . . .... ..... . ..... . . ..... . .... ...... .............. <br />i <br />The work to be esecuted by .�.Cc. 1�j �::� "�' Plumber <br />ii � _ �(,d • U GG <br />Stnte sizc cf ta �� --� <br />// .l�utcr closc' rp � � 7�� <br />p. '- <br />..�.........Tap to Ue inserted in .he main. � � � � � � � <br />�...._. ' . + ..." qU`^�,'� 1 b-��I <br />L.........Dnch ;, Y ilC7 �,1 ,I ,. f+ l' 1 <br />..._.`..'-.....Urinnl , '�Y....., EVE�d � ����^�' <br />OF ' �. <br />� <br />�. iF4 <br />� .....r�� �Et'. <br />.......:........Plnin fnuect in=ide �•,..:,-� <br />_. <br />.__.._-.....Side �cnik �czul�er � � ....... <br />.._..�......_Aose bib oulside ... <br />..__r..:......fIose Lib for building purpo,es <br />............_.IIose UiU insidc <br />.......:........BiU for staUle rnntainin�......_............stnll.................... <br />.......:........Nmvber of persons in tamily <br />...._~�.......NumLm� uf romns in bvilding ` }'� <br />The premise, nre fo be used ns a...'��/7._'__.�.d.<!�!r�-��+�.-c--. <br />. ............... <br />y . .v�t� <br />The o�vner of the Premises is..........._ _.._..___ ............................... � <br />...................... ... <br />ThcngenC is ..................................._..........._... <br />. ........_._ .................................................. <br />This applic.ition, nithough signed, aLa11 not be binding upon Lhe City, until <br />aceepted Uy thm Superinte ent of t ie W�, 1,cr Depnrtmcnt. <br />5igned_v.0 .:.......... ...,....iL\J.Gl.i.j!..F.�iECC//�. �._.............A licant <br />Accenled.. ...... ° �� �.._- <br />16 —.z/. _.....i�_� Bv.. ��l�ifi � ...... <br />- c�rmtendenL <br />