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�,' <br />W. D. Form � �• ' ! •. / <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All Llanks musl 6c filled in ot crossed oul <br />L_ � . <br />Evc.ett. . .. _ . . .....�' '-.�f. .. ts. �. <br />'I'�i'I'IIF; ti1'i'I?Hlti'I�F:NDENT OF TIIE WA7'RR DF.PARTM11EN1': <br />CITY OF EVF.REfT: <br />I hereb} ❑pply fur the use o( wnler in nrcordance u•ith Lhe rul��s :in�l rogu- <br />I,rtinns nf thr Water Drparlment, far pm'poses and fixlures sl:rtrd hrluw. <br />llw'inq thc time thnt nn5• nf thc watrr mains may bc lakcn up b}� rr:isnn <br />��f anp imprnvomen�s aulhnrized bY the City nt F:vrretl, in or of :mc ctmM nr <br />;Jl��c in �chich they may h:n'r Ueen laid, the City «�ill not Ue rrquim<I ln furnish <br />�v:itrr durin�; thi• prngress of such imprnvements in any consumrr �v6use eup� <br />pip m;�y thus br rut ott, or bc 1ia61c far nny damages [or its fnilure so lo dn. <br />ApplicalinnNo../�.¢'.-�.���7���.-. �' . . <br />♦ <br />, . . _'_ <br />Iilnrk ._ ..... ..__..... Lol . � � . Add..:`,:':. ,,•. r,� = .-. � <br />ti� . ._<� -:xr.'-d-Kr. .�, J-' % � `i . �a4"'�s+'y. __ SIreM <br />�+^ie"!•.-��vf :i� G;y� �r—G.� . .. <br />_�/��.{p..._.... _. . ..._... _ .. .. � ._... ......_.. <br />'19ic wm�k lo Ue execuled bp .. . . � <br />St:rt�• sizc o( lap. <br />rIt111111P�' <br />. Tap lo be inscrled in lhe main � <br />.�5'ntrr clnset � � � <br />I3alh � i � <br />� <br />Urinal � � � ��� , <br />]'Inin Inucet insidc � <br />Sidc �e��lk �a�ashrr �{i} ',- •� <br />.fiosc bib oulsidc �7 !. � <br />liosc bib [nr buildinti pm•poses C�S' c'i . <br />Ifnsc bi6 insidc �v/�7(.;; ; <br />.[3ib for stnblc containinF... .. _..sla❑_..__.._. _.. <br />Numbcr ot person, in h�mily <br />.. .Numbcr uf ronms in builJing <br />'1'iic I�remises nre �o Uc uced �s a . . . .. .. . <br />'I'hr awncr of thr premiscs is . . .. <br />�I':ic aHent is.._._.._..._. ... . . . . . .. _ . <br />'fhis applicntion. nllhnu�h siqn�d, shnll nul be binding upon Ihc Cily. unlil <br />.����rptcd by tlie Superin/trndont ��t th ��1'atv Depnrl�}eN. <br />Sicnod C '.. , . .. . � .:��Ji. l:' ( Applir.mt <br />� .,. , • 1P. 14� <br />' tiuprrmlrnd� n' <br />