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, <br /> ` ���w �a„� � � ,�,� <br /> W <br /> ��s � <br /> '�S"�f_-. : t,r <br /> �'w ��: t , .:. t <br /> _ — ,�,., .�� �,( , <br /> . , . a� �� „ <br /> `,�p � <br /> � ��-9-a 7 r,��- . . L.,:.�.�; �- �-�- v,er„-� �;, <br /> 1V.D.Form�—�b00—G8Co.—bY6-21 �1,��. <br /> City of Evei�ett--�Water Department <br /> APPLICATION FOR WATER <br /> All Llmiks must be filled in or cro rd out <br /> _ � <br /> Evcrelt,. � � � ._..13:7.. <br /> . .. .._......................_........ <br /> TO THE SUPERINTB\DENT OF TIdF. \1'ATIiP. DEPART1fENT: <br /> CITY OF EVT•.1t�TT: � <br /> I LeroLy nppi�� for the vse ot�cnter in accerd�c�e uilh the rules r.r�d regu- I <br /> lations of thc R'atenllepartment, tor pm�poses and fi�tures �taG.d belo�c. ' <br /> During thc timc thnt nny of thc n•ntcr mnins mn}•Mc tnken uP �Y renson <br /> of anY �mp raeements authorized by the Cilg of Hccrrlt, in ar af anp street cr <br /> nlley in �vhich they m�y have been laid, tLe City will not bc required to furnish <br /> e:iler durir.g the progrese of such intprot�ements to eny consumer u'hoee euppi5' I <br /> may thus bc rut off, or be linble for uny damnges for iLv failure so to do. <br /> � <br /> APP�'cntion N/o.._.._:'�..7_�.�...........— 9(/'7 7 . <br /> Ulock.....................4?......... �. � 7� Add.__.....� � � <br /> ..... Lot.............. .�..-............... ...... <br /> �3 . .._..._.._.. <br /> No........�.�,i.�<.......... .. . ....................Street <br /> -- .. ......._..... <br /> _'- .--...._ .. . __.. ... . <br /> _ ..__._ ..... . .. <br /> ___.. . ............. _.... <br /> The work to bc executed by.. . . . _.....PlumLer <br /> _. .. <br /> � LC N12C OE LAfI. � O (J <br /> ��...r I{ )1�.!/ � <br /> -....1'np ta bc inscrted in thc mnin. <br /> ......I-._.....\Vntcr doect '� � � <br /> / � l �. <br /> ............Bnth 1 �jJ i1 n <br /> -.............�.Urinnl � �, . <br /> .._...`.........Pinin fnucet insidc <br /> ���.............Side R'tIII( waehcr � <br /> �-L�.-...*_Iosc bib oulsiJe I� <br /> ........._.....Iiose bib !oz building purPoses � <br /> _�.-..-Tiose bib inside <br /> --���_��..—...—Bib for stnblc contnining....................stall..� <br /> ........... <br /> ����/-�.........Nmnbcr o[ persons in fnmily <br /> ��(�.......Number of rooms in building �. <br /> The premisrs are to bc used os <br /> � <br /> � <br /> The o��mer of the premiees is.. ��'��' <br /> .... <br /> . . . <br /> _. <br /> Thc ngent is....... �--"�� <br /> .................... <br /> ..................._._............... <br /> This npplicution. althouqh signed, shall not be bindin.. . ................................ <br /> �ceepted Uy thc Superintendent/�Lthe �VntJcr Drpartment unon the Citp, until � <br /> 5igncd.......,;�.�.1...:1.....!.._..'�....L:::t-:`:'- ''Lt�.✓ <br /> ..�............. .... �...APPlicant <br /> Accepted... .......-..�.1..-�.3�...-...1'J2.!j B /�� <br /> y..._cY . <br /> �� _ .... . <br /> _..... <br /> �Pcrintendent <br /> . ,:=."��3>^,r,. <br /> �,��K'�.�- . <br />