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L N � J <br /> . • Q ny (l�y.��{� ' <br /> \Y. D. Fcrm 1 I SGO d-1-17 C.P. �• <br /> CITY' OF EVERETT=-VVater Department <br /> Application for Water <br /> All blanks must bc filled in or crosscd nut <br /> c,.���«.__-------------- '-,-/�-5----i9� 9 — <br /> TO 7'HE SUI'ERINTLNDIiNT OF 1'HE VVATIiR DCPARTMSiNT, <br /> C1Tl'OF IiVERETT: <br /> 1 hemby applY �or the use nf�caler in ace�xdance with the rulec and regula• <br /> tiuns nf Thc�Vater Deparunenl, for purposes and fixtures sta�eA 6dow. � <br /> Uurinq the time �.hat mry'n( lhe u�ater mains may be taken uP by reasun of <br /> any imnmvements authorized by thc Cilc nf 13cemlt,in or of any sircel or alley in <br /> �vhi�h lhey may h�ve 6ecn IaiA, the City•h'i�� not be required lo L�rnish watcr during <br /> - thr prn�Cress a(such imprnveinrnts lo an}consuntel' x•hn�e supply may thus be eut <br /> n4,nr bc lial:le for any Jamagrs(or ils failure so lo do. <br /> n��r�a��„� N�.---'-� /�_7 --- <br /> 131ock __.__Lot.___"__'_'_._. _.Add.....-._............. <br /> ____'__._'_' <br /> No..__.1.g_�.� __ "�-�`Q`,1r'-�'�.{(/ Strcet <br /> ."_""._"__ <br /> . __.._._'_�.��_��_..U�._'_.__._'______.'__'__'__'.""_' <br /> �_��I'he work to he cxecuted bY._.______'____ '______-.__.__'_'__-__ Plumbcr <br /> State si:s nf L p. <br /> __.��i}..�__Tap tu bc inserteJ in the main. <br /> o � <br /> __'_"_'Nalrrdoset � •' � S "—^ <br /> ._____-.(iath <br /> J <br /> ___ ___ .Urin,J <br /> ____..-_..Plain faucclinside <br /> __ . ____Sidc �calk w�sher <br /> ____.._.._Hnse bi6 outsidc <br /> .__.__.._-Hose bib for Luilding pmpuscs <br /> ....______Ilasc bib insidc <br /> .___"_'_liib(nrstablccontaining_______-_.elall__. ---- <br /> ___'_.___Number uf Pcrsuns in family <br /> -.__._'__'NumUer o(ranms in 6uilding <br /> 7'hr ��remisesarctnbcusedasa__. .____.._-'___. . _-_.__...__' __". <br /> The owner of [hc prcmises is _____— ------------------- <br /> Thca4entis .__.'____.._.. '__._.'___'__" '__ _'__.__'__'-.__._____'_' <br /> 7'his applicatian. although siqned,shall nul bc binding upm� Ihc Cily, unlil ao <br /> cepted b�'TGe Superin�cndent of thc 1Vnter Dcpnruncnt. <br /> SiRnrd _�.-C`�.-"-"`----=---�-'�,-'(,3'A�plican\ <br /> \/,_ V�-�- Y( <br /> AcccPtrd�� --�-`-f�------�`� I3Y���---------'-'------'----- <br /> Superlmenaent <br /> Y.. �:� . O/C � <br />