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�r - �iv I,aJ �-i�-�q <br /> �� <br /> W.D. Fcrm� 1500 J-1-17 G.P. <br /> CITY OF EVERETT==Water Department <br /> Applicatzon for Water <br /> r.11 Ulanks must bc filled in or crosscd,,JJ out <br /> — 'y�Z. t� ip <br /> Ererett.---------------------� - -----'----191�----- <br /> TO 'PHE SUPT•.RINTENUF.NT O�THG WATF.R DIiPARTD71iN7', <br /> C[7'Y O� I 9ERfi7T: <br /> 1 hereby apply tor Ihe use ot��'ater in accordanre with thr n�les and regula� <br /> tia:u nf The W�itcr D,Partntrnt. (nr purpnses and fixtures stated Ldnw. <br /> Uurinq thc time ihal any n( thc watcr mains may be laken up by rcason o( <br /> an�� imprnvemenls auUio�izeJ Ly tiir l'iiy nf Gvercit,in or o( any strcet nr allcy in <br /> �chiCh theY ma5' have 6ccn Inid. Uu•CitY W'ill nnt be rc9��ired ln furnish wate� durin{! <br /> the pmµress n(vuch improvements In any rnnsumer w�h��se supply may lhus be cut <br /> o(L ur be 1ia61e for an���yJJJdamnqes for its failure so ro do. <br /> Z `-` 7 <br /> � APPlirntionNo.�__. /" ______- b <br /> Itlock ---`�7--�--�' ---- Lut--�,--/ . . __.Add----� �---------- <br /> `o.--L7.'� y._�U-�-. _._..Strc�� <br /> _ -- .----- � -- -- - - - -- - - <br /> ����'1'hc work to 1x executed bY-------------------'-----�--'- Plumber <br /> Statc size of tnp. <br /> __.� /i <br /> s___-Tap tn bc inserted in the main. y1z .:' � • <br /> .__ ! {Vatcrclo�et `�� � <br /> -- c ��-t-.:. <br /> __.�.__Dath . �: �._ ,;," .1 ' <br /> l--.....:". ., ' _ <br /> . __.� .Urinal __.'���7i , 't.� .• <br /> � <br /> ___Plain f�ucctinside y' '�/ � <br /> .. ..___"_Sidewalk .vashcr ;'. .• •r.0 %���j ', <br /> y � . <br /> ..__.._Hosehibnutsidc '�� i �'� � .._� ' � �, <br /> i <br /> . _____..--llusebibtm�buildingpurpnses �,,�1`� ��Y , <br /> . .____. Ilasebibinside \v`. �`_- �", i. <br /> _ � \ � <br /> • �. __'__'_"'13ib(uratablecontaininR....._.__., l*•�,.�c�eyy.. '' � <br /> , r <br /> __'..___'Numhcraf persuns in f:miilY � � <br /> ._�p______Numbcr o£roams in 6uildi�ng <br /> - Thepremisesarclobcusedasa_.LLC�_'_c_____._._/_________________ <br /> � � <br /> ..Theouroerotthepremiyesis _Q_v"✓•___�;:.i.��7-�:tc_________.. <br /> "� Thc aqent is <br /> _ '______'..__. _________"'_ _..__' _.__.__"_._____. <br /> This application,althauNh signed, shall nu!bc bindinq upan thc Cily, until :� <br /> cepted by Thc Superintendent of the Wnlcr eparttn nl. , <br /> ��•��- QQQ ` , <br /> SiFned_� _ _'._'�(�_- _".. _ `�Q.4G�a,._'__"'_'Applirant ' <br /> / — t <br /> Acccpted�'__ __.^'_/]9f1� I39 ._ ' - `. ' <br /> Suuerlmendem <br /> ✓ <br /> � r,�' , y�/zo � <br /> , �,,,,� <br /> '�,. <br /> - ����+ <br /> ��. ,�� �,� c <br />