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� ��� -� ��r «<�,, s-�s �, ,,- <br /> w.n.ro�i—�coo—s.eco,—G26s/ � ' <br /> City of Evei�ett�Watei� Depai�tment <br /> APPLICATION FOR WATER <br /> All hlanks must Lc filled in ot crosRcd out � <br /> E��erett.-.._..........-�/L.l�_. .....�_z-............302y1r..� . <br /> TO 7'IIG SUPlT:INTI�:KDIiNT OF T11i: NATF.R IY�PAP.TMENT: <br /> CITY OP' EVEItCTT: <br /> I hereLy aPP�Y tor the use ot u•ater in nccordanee �vith tLe n�les nnd tcgu- <br /> lations of the A'eiet Depattmeut, for pmposes LI1tI fX'UP09 RL�ted hclow. <br /> During the i[me that nny a[ the a�ater maina mny Ue txken up by rensnn � <br /> ot amy irv:prnacments avthorized Ly Lhe Citg nt Lcerett, in or ot eny xtroet or <br /> a9ep in whirh lfiey may huee bern laid, the Citq will nol bc required to furnixh <br /> w�nter during the progre�s ot euch impro�•ementn La any coneumer whose supP�S <br /> msp tliun Lc eut nff, or pbe Iinblc for r,ny damages for its fn{lure su Lo do. <br /> Applicution 10..__(J.. � _ �"t'��e i. <br /> y _�.... . <br /> ri��k ....._ b?.-5.... �p�c.._l.. . .. aaa. ..._ _ .... <br /> \o_ .. ..��1......r(,,.,. 4�!�... ......Sheet <br /> ...._.__. _....._.................._..........................._.._M_.. ........_..............__.. . _ _. .........._....__...- <br /> The work to be executed by...._ /,}�e�.-w—� ........Plumber �" <br /> ._._. . ...._..... ._ ...... _.... <br /> StntR size of tep, �. D• <br /> .....�4...._Tap to he insertecl in lhe mnin. ,L <br /> .._........---.Watcr dnset �(}��� <br /> ......_......_Bath �: u. <br /> ............._.Urin Bl <br /> ..._. ........Blain faucet inside <br /> _._._......_.Side �calk vrnsher <br /> _ _...........Hose Uib outaide <br /> ................Hose bib for building pmpoeea <br /> __............ITaee bib innide <br /> ................Dib for stnblo containi:�R....................stall.................... <br /> ................Numbei' oI Persons in family <br /> ......._.......NumUer of roome in build(nq <br /> The Premiees are to be veed as a.......__ _.....__. ._._....._..............__..._..__........... <br /> e oa�ner of the premieen is._...._ .__.....__.. ._ ......._..................................... ........ <br /> agent; is_.........._..................................._.._ .........................__....................._......... <br /> . applicnLion, aithough signed, ahall not bo binding npon tha City, until <br /> by the Superinten�ent a£ th�e R'ater Depnrtment. � <br /> Signed...��IJ3f-fi"s?/,�71P1_��.y,J.�i��Q�.. �4Cn • .......Applicant <br /> ( .....,. � �.��ar.. <br /> � , <br /> v..��..._...iay�.. By_l/�................ ... :„ .. <br /> � `/���� p�. <br /> � <br /> � <br /> _;T <br />