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..y r..—;c-rtv-zL .�-.ti.l.'.. e.c' . . , <br /> . (" ln_ I'i- '. i( � <br /> �V.U.Porm 1—If00—F P.Co.-6�".G�YI � ' • <br /> City of Evei�ett�Watei• Depai•tment <br /> APPLICATION FOR WATER <br /> All binnks must Uc filled in or crossed out <br /> liverett,.........../� � �/ <br /> ....� ..�..0.......................................192...... <br /> TO TIIG SUPliRINTPA'UPNT OF TIIF. \;':YCIiR D&PAP.TNENT: <br /> � CITP OI�' CVCi:CTT: <br /> I hereby npply for ffie uac of�v:iter in nccordvnce��'itF thc rt�le.: nr.d regu- <br /> lations ot thc Nutcr llepnrtment, for pm�poses nnd fixture stated Uclu«�. <br /> During the time thnt any o[ N�c �c�ter mains mny La laken up Uy rensou <br /> of nny imprnvements authm�ir.�•d Uy the City of Ecerett, in or of nng street or <br /> nlley in �vhich �hey� may hn�•e 6een la�d, the City �vill not be rnquired to furnish <br /> water during the progress of suc6 impro�•ements to nny consumer whose supply <br /> n:ay thus be cut off,(o��r Ue linblc for :.ny dnn:nges tor its fnilure sa to do. <br /> Applicntion No..a.....�.J...�...�............... <br /> Block..............._�_`::.......... . Lo�t ... �... . Add...._...._ _...._..._ _._.._ ... <br /> No....�.��. t.�...._�.�.�[�L:�../..........._......Street <br /> .........__..._...__....._......._..._......................._._.........................................._...................._........ <br /> The �vork lo be e�ecuted by._._ _...���Lf/f7.................. ......P1umUer <br /> Sta:c size of tnp. <br /> �2.......Tnp to Ue inserted in U�e mnin. <br /> ..�...........R'nler closet <br /> � ..L...........Buth <br /> ..X.....__Urinnl <br /> ..�..........Plnin fnucet in�ide <br /> ...�..........Sidc wnik �vnshcr <br /> ....�.�......_Ho�e biU outside <br /> ..,�. IIose bib for building purpo,es � � <br /> ......... _ ._ <br /> .. . . Iiose bib inside <br /> !/ �� . <br /> ....... <br /> ...........Bib for stnble contninin �S� ��,�- <br /> � g........._........slall.................. ._ - <br /> ..,�......_..Number of persons in family ���. <br /> ..�........Numbcr of roon:s in building . <br /> The premises are to bc used ns n.....__. r�,.L.�.<(.C�(�..�� .L�............ <br /> 1'hc owner of tl�e premises is......�,.�.�._. ..�l,� �i ' <br /> � o —' �..._......._. <br /> Thcngent is..._..........................................._._...__....._..._............_.......�.........1.......... <br /> , his npplicution, nithou�h signed, ,hnll not bc Linding upon thc Cily, until <br /> � �c� Uy the Superinten ent of the Nater Dep/nrtment. <br /> Signed.y�......�../`:./.J...._.!•����G�..CC� .. ....... ppl aMit <br /> ._(.-.. . ...... <br /> � .. _ Ar�•' � /Q...�.1�...........�J'�' .. By.. a .... ' 1 <br /> � .............. <br /> � . 'ntendent <br /> -c�. _. ... .. . .,�. <br />