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T. _ ' ., i . _ .._ . i .'J 7�- l" � r <br />� K'. D. Farn. a I500 J-I. V C. P. � • <br />C[TY OF EVERETT==Water Department <br />Application for Water <br />All 6lanks must be filled in or crossrd aut <br />���.�«. ---------- --9�-3 - -- ��/- <br />TO THE SUPGHINI'ENIi6NT OF ]'!IG WATFR DEPARTTIENT, <br />CITp pF GVEHETT: <br />I hereby apph• (nr the use o( wa[er in accordance with the n�!es and regula• <br />tion: nf The Water Uepartment, tnr purposes and fistures statcd bclow. <br />Durinc the Limc tha[ any ui the x�at�•r mains may be [aken up by reason of <br />am� improvemen[s au�horized bp thc Cita o( liverrtt, in ar of any slreet ar alley in <br />�rhich they may have 6een laid, the City w�ill no( be mquired to (urnish xaler during <br />�he prn�ress o( .uch improvcinents tn any cnnsumer w�hnse supply may tlms be cut <br />o(f. or bc liablc tor aiiy dam:�grs (ur its tailure su In dn. <br />7 � <br />ApplitnlinnNo."_�j�' ".5""_" <br />Hl�xk �� Lo _"""_""_' <br />'.�__ q_ -_ ._ __'_._'.__. Add._____._ <br />.__.No._'_.__...__ !_�.�___✓ ' _ '__.____ �__..Strect <br />""_"'_"__' "_"'""" <br />"1'heu•orktnbeczeculedby.___...__"'___' __________".__'______' Ilumber <br />Statc size �it tap. <br />.��L__Tap tn be inscrted in the mai�. <br />___.____{Yattrdnut �*�` � <br />-.._ ..�_ <br />__..._ ___��Hl�l . . . � - �-l•4�., /: <br />__ ____ .Urinai � � .,-��t�a`� . � <br />________Plain faucet inside �! �--�`'Xi,�„�� <br />. ________Sidc nalk w�sher . . � � � <br />.__.___.._Hoscbiboutsidc � � ��- ����-��...���� pi <br />�� <br />-----'.__.Hosc bib fnrbnilding pum�� � ��-�T i <br />� ' <br />.._.___,Hoschihinsidc /, � ��C <br />._""_"'13ibtorstabie[unlaining._/_�__.�.�.`-eWU ,7?�' <br />j�. <br />_________.Numbrrufpersonsinfamily "•'-- � <br />___�,___Number o( rnoms in building <br />Thepremisesarctobeu�edasa _.._.___' ' __"'._"' _"___'_ "'_" <br />The ow�ner nf the premises is ..___'_________._'__..____"__'_______"_.__"_ <br />Theagcntis..._"_"_"'"'"'_'" _"'__.. """_ "''""'_""' <br />This application, althouqh signed. shall not bc binding up�m the City. until aa <br />ccpted 6y The Superimenden(l/u ic 1Vnter Ucpartmenl. <br />SiRncd .� .l � .�ou _��( ('//,1.UiJ���_' Arl�lican[ <br />Atceptrd �j.�.�_---y�/ /_____."'_'______.__ <br />/ �� sup<rlmmaem <br />: <br />°�, <br />� � : ' .7"i <br />Jy �:;,;� ' <br />'iv^_ <br />. .. +.L�;L7 <br />, - . � � �.�'�`.:d} <br />