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._. . ... _ ,.. . C�nirD'.F'/�'T3-l7]_ <br />. . _� <br />w. J. Porm 1 1;00 d-147 C. P. <br />G1TY OF EVCRETT==Water Department <br />Application� for Water <br />:111 blanks must bc fillrd m ur crnssed nu <br />L•'vcreu...__'___._ _ y // �--__'___19f.c2--- <br />'PO THB SUP6RINTENDIiN1' OF'flilb 5Y, 1'ER DCPAHTTIEN7'. <br />Ci1'1' OF L �HRET7"� <br />f hcre6y npp1Y (or Ihe u�e o( watef in afcm'unnce with Uie rules and regul�� <br />tinns ut Thc WaL�r I)ePartm:nl, fur purposes an�.l lixturrs staled bclou�. <br />During the time that anp nf ihe aat�•r mains may br takcn up hy reasun of <br />any imnrnvemeu�s nuthorized by thr CitF ��( Gvcrctt, in ar ut an}' strerl ��r allcy in <br />�vhich they miy hove becn laid, the City x�ill not be required ta lurm�h aater durin(� <br />the pro�ress nf suclt improvenu nts tu an)• mnsumer n'ho=r suPPly ma}• lhus br eut <br />,d(. or be liable Cnr anY �a/m:�K(.e": fur iis (nilw'e w«i do. <br />ApplicnlinnN�oy...�(2'O _�'-'--�'-/ �_ <br />Block_--/�1--�' _-/ �Lot__p /��Y�-'.�J-----Add._-------�---'--- <br />\o.__.�e_�.�".LJ.s��(l.�!/ _'._.___..Svect <br />/ <br />_"" <br />.""_' . "_'"_'_-__.-___"'___""' _'" <br />--�� Phe n�ork tn bc caecuted bY-----"------' '-- -� --�'---"----- Plumber <br />Stale zc 9[ tap. / — . %✓ ` <br />�/ � <br />__��C_."Pap tn bc inscrlcd in the main. `� r <br />_'._ �..__Water dnset <br />'_" I_...Ilath <br />'__._' .Urin�l <br />_ _______Plain faumt;nsidc <br />______'__Sidc walk a;.:her <br />-- "-'_'._liusc bib ou:ei�ic � � <br />' ___Hosebib;orbuildingpurposes <br />'_"'___Ilnsc �ib insidc � <br />_"_""__I3ib fur etable conlainin4 �---'-------tlall__.."'.� <br />%Number o( persuns in f�mil>• <br />_._ _f7"--Number at room� in Luildinq <br />'1'hepremisesarrtubcusedasn___..__'__"'____._.._______________ ______ <br />7'hc o�ancr of thc Premices is _"__..____"'_. _'.'. _... -_._"__-__.__'_'____.. <br />Thca6enlis.."_.___...___."'_""_"'___ ._.'___._"'__.._ <br />This applic�lion. although signed, shall nol hc binding upnn Ihc l'ilp, unlil ae• <br />,�pled by The Superimcnden � ie /15'./�1'er Uep7��y �/i nt. <br />Signcd.yf�u_'--r_-.L��"---�-�--''_"�-'-/� �PPlicant <br />/-� �. <br />AccePted..___.._-.___--_.191 8)'_.__'_ ____' _' <br />SuD��lotendem <br />_"' '___"""__" <br />-` � /' — = -� �?�'� <br />