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fNr� ., ,.,i/,, <br />e, o. r��,��� a icoo i-i-i�c.P. <br />C!'�'Y OF EVCRETT==1'Va�er De�urtment <br />��pplicatiora for �rii��ater <br />All blanks must be filled in nr rrossed uut <br />��'� 3 <br />L'vereu_______________________._.' �_.�.._ ..;Jl <br />"CU 'I'lIG SIiPBRINTGNbii�7' OP 7'IiG W:\"1'I:IZ lllil'Alt'1'A'k:�'I'. <br />CI'1'Y OP ii9l?ItIdTT: <br />1 hemby:ipply fnr the use u( naler in areord:mce with the nile, :md regula� <br />ti�.�ns u( The AVater Dzpar[in_nl, [nr purposes and fixtnres slr,;ed bclmc. <br />Durin�; the time Ihat any of the wnter nmins map bc takrn up bp rea�on o( <br />an�' imP���vemunl+auUmrized by lhe Citv u( G��ereu. in or oi anc s�rect ur nll��c in <br />�,vi�ich they m:�y have bcen laid. Ihe Cily «�ill nnt be rtquired tu lurn��h �r:urr Jiuin�t <br />ihu proy;re�s uf such improvcmcn[s tu :iny ronsumcr �rhn=c sunply m:�y thcs b�� � ut <br />��(f. or 6e liablc for anY rd;unages frur i[s fnilure s-o tn du. <br />Applicntian No.'_'_[_�'�"J_'_____ <br />Iilock __�'� � '___�..oL__'__..' ___ ._. AdJ . _ __. . . . <br />Xu.__..._� __ �.C�[.. <br />,1..8 �1 -----1-6._ --._S�,«< <br />_ _ - --- ----- --� ---------- ---- ---- - - <br />'I'he �eork lo be esecuteJ SS'""'_ . �-�_ .- . . Plumbcr <br />� �� <'l �a�-C J_ <br />titntc/ sizc ��f tap. <br />.(.�'�"I:�p to �• i�rsrrled in Ihc main. <br />_ . �-----N:ucr duset <br />13a1h � <br />._ -F-__- !., <br />. _ .Urinnl ��i . <br />..._ _.Plain (aucetinsidc <br />. .___Side w.dk «nsher .� .r` / �'�- . <br />_.'_Hocc b�b oulside � ���� � /� . <br />�.! <br />..-_-. _ _Hos�� bi6 forbuilding purpnses _ � � . <br />._____.Nnsebibinsidc � ,^'1! ��" <br />r <br />_ _ __.__-Ilib fnr sl�blc contai�d�g. _ __ _. _. __ _. sLill. ..._ __'.'f <br />.. ____Numbrrofper.,ansin(amily '. <br />:.: ,�. 4r� � ; . <br />. _�. ____Number n( rooms in building '���i��,� ='--�-. <br />�:.:��!'.�'� : <br />Thepremi�c,aretohcusedasa_______________'._'. "_" "�,...�� <br />"Phc owner of the prrmisrs is _._.' . -. __ .. _. _. <br />... ____ ..._-__-__..... <br />"I'hcagentis _""_".....________ .___'_ __' '___. _ . <br />'1 his npplicilioi,. �IthouFh :.�{t(ed. s/l�il�'f bc qin� � upon��e Ci y, untii ao <br />rcptud b��'1'heSuperin�ende � heJ�y �1� r'/,`�'r_ ['a'n'�9i•i <br />Sil�ne�l' _��� 1--�//_.�;i`,:" ��.� ���"' Pl�litant <br />.l ' . <br />Acrepted.. �,...�'____.�.11/ I��lii- � r%� ` <br />: .' 6 ,_'.�,. _-__.. .� ,;.;.;:.:.._ <br />.._��/ �i,�/., ,5�, <br />