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.. . / -___ <br /> N'. L. Form: <br /> CITY OF EVERETT—WATER DEPARTMEiVT <br /> APPI,I�;ATIUN FOR WATER <br /> •111 bl�mks n��ust hc fillcd in or crossed out <br /> Cvcrclt�. ... . . .� C,. . . _. .. .. . . . 19. � . /� <br /> _ rr'c <br /> TO 'i HF. !iUPI';41NTENDEid'f OF TIIE WATF.R DF.P�IRTMENT: <br /> CITY OF EVF.RETT: <br /> 1 hcrebp apply fnr thc usr uf walcr in accurdnncr ciith lhe rules and regu� <br /> Intiuns nf lhc R'alcr Drp�rlmcnt. fur ptn�poses and f�xtures slalcd bclotv. <br /> lluring tho timc that anY ��. thc tt�rlcr m;nns may bc L�kcn up by rcoson <br /> o( an5' impra�:unmrts authorizcd bv thc City u( F:vcrcl•.:, in or ot any strccl or <br /> allcy in which lhcY may h;ivc bcen�laid, thc Cit• will nol bc �rquired to furnisb <br /> w:ilr.r dw�i�,p thr proq�rss uf sueh improvemcr. s to an.Y consumer whuse sup. <br /> ply may lh��s br cul uff, ur be liable for anY <�.images for ils tailure so ln da. <br /> APPlication Nu._.��('.�.-�^_ �/ <br /> Lllo�k. ........................ . _ Lot . . ._... <br /> /A . . . ... . .... Add. . <br /> Nn.. . .. ..._.__. _�/..�_O_. ... . .i...<:C..1.�-t...r..n....�.�f .. Slrerl <br /> ._ ... ... ............ ...__._ .._ ._...__....... . ...... ...... . _.__...._ . ... . . <br /> Thc work lu be executeJ by. .. ._. _ . .. . . .. . . Phunhcr <br /> �s��i� s��� ot a,N. �' <br /> i <br /> .._.Tap ln be inscrted in Ihe m.in. `'�� � �. <br /> / , <br /> .._._...Watcr dnsrl � ;%� , <br /> ..... ...._Dath ''' � �' � - %••� r '" <br /> . __Urinal �l•l " � � <br /> ___.Plain L•mccl insidc . ',. " C i' , � �r�t�l�:�c � . <br /> . . ._.....Sidc walk washcr . <br /> /, Y <br /> .. _....._Iluse bib outsidc '. :� ,. ��.�lC-!' �id`'-�' '� ��O <br /> ._.......Hosc bib for buildin;;Purposes . �/. <br /> . ........._Flosebibinsidc y ''� O e[l-J -:'_r-:, :.y'_ y <br /> . . _....➢iU t ir stablc containinp...__...._ _._stall.��r"'-�_�, �i. ..., <br /> . ._.Number ot persons in tnr.iily , <br /> ._ _N�mUcrof �uumsinhuilding �f �; ��,�,�� �,<'���1�'.. . , <br /> :'he premises nir lo bn uacd as a __._..._ .. . . _ . . .(Y.� ... _. . _ �,� <br /> 7'hc ownar uf �h�� prerni=rs is_... . <br /> '1'I,�, u�cnl is__ .._ _.. . . ... _.. .. . .. . . . <br /> . .. ... . . .._ . .. .._ _.. . . <br /> 'I'his applicnllnn, al�houph eipned, shnll nat hc bind_n„ unun ':',.., CiY;. until <br /> urvc�ricd by thc Suprpi�itrndrnl nf lhr Wnlcr Dcpartmrnt. <br /> Si4nfv{, .�. � .�(�1��: �t� .-�/- _ . .Applirnnt <br /> A�•����plvd �n. Hr <br /> tiuprrinf��ndrnf <br />