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W'. DrFcnv t I5�0 3d-17C. P. ,-N�-D3`te—� � ��1� <br />� ; CITV OF EVERETT==Water Department <br />' Application for Wate�r <br />All blank� must 6c filled in or cross mt <br />i � <br />Everelt.-. '_ _ i � �D — - y� � -. <br />/, <br />_ "'_""_' "' ' "' '_'1 """_' <br />TO THE SUPERINTENUIiN7' OF THH 15'ATL'R UEPARTAfENT, <br />C11'Y OF EVL•'RE7'T: <br />1 hereby apply fnr the use ot aatr.r in accardance with the rules and rcgula� <br />tions of The Water Depar[m_nl, !or purposes and fixmres stated bclow. <br />DurinR �he time that any o( lhe aaler mains may be taken up by reasun of <br />anp improvemenls authorized by the City ot Eventt, in or o! nny strcet or allcy in <br />a�hich thry may have 6een laid, the Ci[y will not Uc requiced to furnish water during <br />the prngrecs of such improvements In any consumer n•hose suppl�� may thus bc cut <br />nt(, ur bc Iiable for any /da�m/ag5es �tor its�failure so to do. <br />APPlicntion No. _ _ Y1"/_ _ /- �'' _"' _' <br />IIhxk -' '.�'�0 .Lot 2"/—�— —'�-- Add----.. <br />'---- -- <br />No.._ �"� � _ .. < '--"Strcet <br />"'_"' " "' ' " ' "' ' ' ' ' _"""""""'"'" "' <br />'Phe work to 6c executed by.."""'_""".______"'_____'_'_____' Plumber <br />Stat� ize a( tnp. <br />i � <br />---._ y_T,p eo be ins�rica in the main. / j p c <br />l <br />-"'-----'1Vatcrclaset LJ � <br />"_.___.13ath <br />"'_..__ .Urinal <br />'•_"""_I'lain fnucet insidc <br />._______Sidc walk washcr �- � <br />� <br />'__""'._11usc bib outside � <br />._____ _.Hosebib(orbuilJinKPurposcs <br />_________.Ilosc bil�inside <br />-""""' Uib tor <table containinq. _". _ _ _ . _ _ slalL _. , _ � <br />. ,l Numbc* ut persuns in family <br />"''"�__ .\'umherof roomsin building <br />The premi,es are to be uscd as a_.___ __________________ <br />__"_'__"" _"'•' <br />'fhe oa�net �d Ihe prcmises is '_. ""______"'_._'_____"'_ <br />____'__'_"_"'_ <br />'.^�;�c,:cntis..'.-----_ _..'---.'-'-'_-- <br />-----' _--- ---- <br />'1'his applicntio;i nithough siNned. shall not be binAing upnn the Cily. unlii aa <br />� bY The Sup:riulcnpd7ent af Ihe Nnler Ucparlment. <br />^ SignedYl___CY-V/._��.(,c/�/17_ _ _ /_'_"_'__ ApPlicant <br />_ __. ' __ <br />ccepled__'�__2<P.__�3 13y._��/ ' <br />_' _ '_"""_ "" <br />P.uoenmendm� "_ <br />/ <br />a <br />�a <br />� r ���A <br />-�������%� t „� i <br />