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�. �/•�. .. ' <br /> a', D. Foim! <br /> CITY OF EVERETT-WATER DEPARTM�NT <br /> APPLICATION FOR WATER <br /> All blanks must he tilled in or crossed out <br /> -- . . .. � '' . � � . <br /> Everctt,....... ._. _ ' .�-a.�-_ — i..... _ . .. t9s'_�. <br /> TO TIIE SUI'h:RINI'F.NDF.NCITY OF EVF.RETTll��ARTMENT: <br /> I hcreby npply for lhe use o[ wntr.r in nccordnnce with the rules ond regu- <br /> latiuns o( the V✓nler Deparlment, for purposes nt�d (ixlures stnted beloW. <br /> DurinC lhe time thal nny of thc wntrr mains may bc tnken up by reason <br /> o( any improvements authorizcd fiy thc Cily ot Everclt, in or o[ any street or , <br /> alicy in wh�ch they mny have bcen Inid, lhc C�LY w��� not be required lo furnish <br /> water during the prngress of sUch improvrtnenL, lo any consumer u'huse xup- , <br /> ply may lhus bc cut o[f, or bc liable tor any damn�es for ils tnilure so lo do. <br /> Applicntion No....G�.:��..C.�"^......._... <br /> .__. Lot_ ..r.?...� . Add �l'%. : <,.!,a.�._.i ' ..:.'' - <br /> Block. _... ..._......_..__ ._ _ . ... _ <br /> No. E .r � �- ��� � ....:,,,,_.._ ..���`.—.. . ...........__.. __... Streel <br /> ..._. _ _._ ___ .. .. <br /> ._............................_...._.. ....._._..._.............................................. ........___...__... .__.. __. <br /> The work to Le execuled Ly. _. ._._._. .... . Plumber <br /> Slnle sizc ot lnp. <br /> r <br /> � .,1:�..Tnp lo bc insertcd in lhc mnin <br /> __...........Watcr dascl �. <br /> ,�. 8�,��, p � � p <br /> .....Urinnl ' , J L. <br /> . .Plain faucel insidc �6� ��' � <br /> __... ._.....Sidc µ•nik w:��-� � <br /> _._..._......Husc fiib ouleide _t [:yp�cit '� . i `� � <br /> t �._.._..._....Hosc bib (or I�f�,�lm�_A�,I�;s <br /> _. ._._.._Ifosc bib ins�i'1F�1G�2 UL <br /> .....IIib fnr stnble conlnining... . . sl:dl <br /> �`�..Number of persnns in tamily <br /> �.._.Numbrr ot rooms in building <br /> 'I'hr prrmiscs ure lo bc usrd ns n.. <br /> 7'hr owncr of lhc premisrs is.. ._. � <br /> 'I'hr nFent is..__ _...._. . . . .. . . _..____..._._..__ .. . .. . . <br /> '1'hi,: applu.nlion. :dthnuFh sipn�d, �hall not br bindin� upon the Cit;,, u�dil <br /> .irrrpto�.l 6y lhr Superinlr enl nt thc Wator Dcpnrlmonl. <br /> S�Fnni�. _.�C��,��� ..����C.�Q�/�.._..Applicanl <br /> � <br /> .4���•rpird 1P.. Ry. . . _...... . . _.. . . ./ <br /> ..Fuprrinlrndenl. <br />