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' .a �nITA �-1-/S-'<o �/-1 , <br /> /` � <br /> W. D. Farm � I500 J-1-17 C.P. , <br /> CITY OF EVERETT==Water Department <br /> Application for Water <br /> All blanks must bc fil�d in or cross=u <br /> � �� 7J) <br /> lecrc�t..._�`':��'-l--'��__"__"'_"'_191=Y__' <br /> 'PO THE SUPF.RINTENUIiN'f OP TII6 NATF.R DGPARTMENT, <br /> CI'll'�OF E`/LRETT: <br /> 1 hereby apply for the use of w:ucr in accordance u•ith the rules and rcgula� <br /> tinns of Thc�Yater Deparunent, for purposes and fix[ures s[ated below. <br /> During lhe time Ihat nny nf the water mains may be taken up by reason o( <br /> any intPrnvements nuthurized Ly the City ot Gvcrett.in ar of �nY s�rce[ nr alicy in <br /> ahich they may have been laid, tl�c Cill'will not be required to furnish watcr during <br /> Qic Prngress of such imprnvem�nts lo any consumcr whnsc supply maY thus bc cut <br />� utf, or bc liablc(or any d:unages (or i[s failure so ta do. <br /> � c� <br /> Applicntinn No."' __'_" "__ ._ <br /> BIocA .'__" ___' .__.,_I.AL____..--.___.___.Add____._______ _______ <br /> �j � <br /> ..G<S c> f ��[.!_ - �----..Street <br /> No.""_" _"' _ G'_ln!L <br /> / <br /> ___.._""' """"__ _ ' <br /> ___-f he work to 6e executed Uy'____""""__' '__"""'___________' Plumber <br /> Statc/.y'2e nt tap. <br /> _./!__Z_Tap to bc inscrted in[hc main. <br /> "'__-�__Nalercloset �j�r-UQ — <br /> " ___6alh <br /> '------' .Urinal - � �� <br /> �� t�. <br /> _""""'Plain (auccl insidc „j �'��j, � <br /> __'____'_Sidc walk washcr /`'���`�J nA � �\`-^, <br /> '__ <br /> '__.._Hosebibuutside V i^/'rj i� <br /> .� il��, <br /> """'___Hosc 6ib(orbuilding pwpos'es �--� <br /> ________ HnScbibinsidc !1F'F( �S ]q'�Q <br /> '_""_"_Bibforstablecontaining-____'__.__stal F__ "�� ,r . <br /> � �"" :: <br /> . Numbcr aC persons in (amilY \�t-� .=�.� ; <br /> ___�_Number of ronms in builciing `C'-�.r f%% <br /> 'fheprciniscsareto6eusedasa____'-____""'__""'."_"_""""' ___._. <br /> The o•,ener o(the Premiscs is _____'__'___.__."_'_.__'_'_'_________""'____. <br /> ThcalCentis___"____..__.___.___""____ '___.____'_'_"_ ___'._"__ <br /> This application.allhough signed.shall not be binding upon the Ciq�, until ac� <br /> cepled bY 1'he Superinlende� o the �Jnler Dep,a/rtntenL _ <br /> SiHned�"�`�C_✓ 13;� �fc���'�___'__ pPlicant <br /> "" <br /> ` _ <br /> � � <br /> Accepicd�- --�J -�'✓ By <br /> -_____ . " ' "' __""_. <br /> � 5�¢��rea�r..�i <br /> � \ /v/�G ��=r� . . .-�� ' <br /> . ,...t__/' • i <br /> —�; -.. _"-'.+• <br />