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` �1 <br /> .cc /0-12-1k-/r � ' Y��-�.-�_� 3"�'�' � � <br /> W.D.Form�-1G00—F P.Go.-628-21 � <br /> � "'*y of EverPtt-�Watei• Departrnent <br /> ..'�LICATION FOR WATE�Z <br /> � All blanks mu:,t Uc filleJ in or crossed out <br /> �«t�«,..........--...G'_. ,.....9 ...����.. <br /> ,................ <br /> TO THE SUPERINTENDGNT OF TIiF. \1'ATER PAPTD[ENT: <br /> CITY OP EVERETT: <br /> I hereby nPP�S for the use of�vater in accordance with the rules and regu- <br /> IaLions o[ the Water Depnrtment, for purposes and fixtures stated bdow. <br /> During the Limc that any of the water mains may be taken up by rcason <br /> of nny improcements authoriud Ly thc City� of Eecrett, in or nf any etreet or <br /> alley in which tfiey mny hace Ueen lnid, ihe City will not be required to furnish <br /> water during the progress ot such improrc �ents to any consumcr whose suPP�S <br /> muy tlms bc cuL otf, or b IiaUle tm� :my damagns for its fnilurc eo to do. <br /> � �' �'� <br /> Apptiwtion No............:c...'....:......._..... • <br /> �, .. - � 7 t C.,r(.�L <br /> Block ....... .. . Lot .._ � ...... ... Add. . _.. _.. ... <br /> Ao �� 0 Ur . . _ ._ . . Street � . <br /> �4�/._. .. . ..... . . ..._... . ...... <br /> .. ...._. _......... . ... / <br /> The work tn be executed bY......_.__-.._.�. ._._. . ...................._. ...;.�Plumber <br /> 5 L uzc of tnp. <br /> - � .`\� . <br /> .. .�{.....Tap to be inscrted in the main, a �`} <br /> .,,,.'�......._Natcr doset , O ` \,� <br /> V . <br /> .L�..13ath � , ' . .. �. : � . � 1( � <br /> ..... . ....Unnal . � Q .. � � )C-�, <br /> �....Plain :uucet Ins�d`e'���' , � � <br /> . ( <br /> �...�....Side a•alk «�dsLcr�' � f . i�� C r7,�� � <br /> �..Hose bib oeCside �� Q � �d <br /> - <br /> .....'—:......Aosc bib for building purpoecs %� / / <br /> .............._]iosc Lib inaide b <br /> .._� .—:.....Bib fot atsble contnining....................atall.................... <br /> _�.-r.:......Tumbcr of persons in tnmily <br /> .._`...........NumUer of rooms in 5uildin \��y—�--�5�� � � <br /> The premises are ta be used as o... . ..�.... ..-�-.".-*!„�.r��L--�-� <br /> The oa•ner of lhe Premises is...........�......._. .�.......... . <br /> Thcngent is........................................._............_............................................................. <br /> Thie application, althougl� signed, shull not Ue binding upon the Cily, until <br /> aceePted Uy the Superinlendent of the Nnter llep¢rypent. <br /> � _/ /n� //_ <br /> SiCned...... ..........aL°.�lay�C�...UG�� . ....liV.......-.�..-...................Arpiicnnt f <br /> n���rc�a._.10...:�..._.........ioz.tt,2' sv . �t7rlU(„EfC��ct�,��r-�.�........ 1 I <br /> �� � p� Su �n/tendrpt � <br /> -�t��li���fr� � <br />