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(� y�'�4 <br /> v�'s/i�%3�i� 4:..�-_`�.1 cf _r &,-3l �r— <br /> W.D.Fnrm�—I600—E,p.Ca.—�'6-YI � <br /> ~ City of •Evexett�Watei• Department <br /> APPLICATION FOR WATER <br /> All blanl:s muet be filled in or cros�ed out <br /> E��erett...........................�..�.�..P...........................1!�../. <br /> TO THE SUPCR[NTENDENT OF TI;P R'ATER DEPARTIIENT: � � <br /> C11'Y OR F.VEI2ETT: � '��;x;�.. <br /> I hereb o I for the �se uf avnter in accordnnce with the rvles nnd xegu- � �z� )S��.c <br /> Y PPY t�+a;. <br /> lotiona of the {Vatcr Deparlment, for purposes and fixturca F'a�ed bclow, i �;,,,�_�°;,.� <br /> During the time thnt any of th�� tvatcr mains may be taAu� up Ly reaem� 'e ;ni �; - <br /> of any improvements authorized by the City of C�•erett, in or of any etrect or } fi ! <br /> u h <br /> alley in which ihey� mny hnce Ucen laid, the G:ly will noL Le required to lvmiah ���� <br /> water during the prcgress of such improrements to any convumer whose suppl3' � n <br /> mny thun bc cut oif, or te linble for :my dnmaFes for its fnilure eo to do. ���_ e„��'.3' ;�",_. <br /> ..- c� n .4 ��,�:-.• � <br /> Appitcnt�on No. ..f-.'��.Q..d......... l�i. � r � r . <br /> L'lock.. ....... .. ...... Lot...... ...._ ..................... Add._._...... L`,. si� w� '�'<,., <br /> �r 5 � <br /> S .............. � �� <br /> No.. ... Strcet �'. i� <br /> � _ I..$.. . . .... ......... ......_...... �, � � <br /> .. ,���� <br /> ....... .........._....... ... . <br /> _._.......... .__.........- , . <br /> The work to be execuled by. .... . _ ..._..... . .plumber ,{��+�F ��'� <br /> . __.._. ..`_ <br /> la size of tnp. (� � � , . _} <br /> Tap to be inserted in tl:.e n. — ^ y�-� ±�.����� <br /> .............R'nter daset � ��„ Q <br /> f � , � ..a . ,i <br /> ...............Bnth ''-�... � � : '��' . <br /> '-........._...Urinnl L�I .........,, � � . �1, '+{�.... �i <br /> �� <br /> ........ .....Plnin faucet inside �U31Y,y "' ., � ��` ' ' <br /> �y� �i�� .. <br /> ...............Sidc wnik u•asher `eb� �� -"T�f3 ^•�'(S ;p �e . <br /> � ... ,s��.� �: <br /> ...............lioeo bib oatside (� t �C��'��� � �, j "` <br /> �i �j d <br /> ................Hose bib for building purposes g [y/ � ' F r�"yµ -a - <br /> � :::� <br /> . � �y � A' <br /> ................Iias� bib inaido � � !� ., ¢�I� <br /> ... � '- .:•.�� ,wl �. <br /> ................IIib for etable cantaining....................stall................_...`� . .�:. . . . <br /> ................nvmber of persons in family <br /> ................Number of rooma in building <br /> The premiaea ere to be used as e........... ^ - <br /> .. ......_............._................ <br /> ................ <br /> The orvner of the Premises is.....�_.....�,p�._. <br /> � <br /> . <br /> . ....... <br /> Thcagent ie........................... .. ............ ....... <br /> . ... ...... .............. . <br /> .... .............. <br /> T>>j9 �PP��c�Nan, althouqh signed, ohall not be binding upon tho City, until ��� - ' <br /> o�� �ted by the Super(ntendent ot the N ter De nrtment. ' � ` <br /> P <br /> / <br /> s��,�a..........�h.... ...;.:......G??�''e ,.......................>6nrlic n <br /> / � / 'I ,��sF <br /> dc:epted...f.:.l�.:..'.j..1...1D2...... By....�/l....�i..�....�y� .. . � .. , . <br /> �� .. <br /> _ . ._ . . _ . . --- ----�- -- � <br />