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l <br /> 4 ENT`� O-/S'Jo . . <br /> \'.. D. Form 1 I E00 J-1-17 C.P. <br /> C1TY OF EVERETT==Water Department <br /> �pplacation for ter <br /> all blanks must bc fi in or cr �sc �ul <br /> ':cerctt.---- �— -----'.1'3F'.L�— <br /> TO 'CHL SUPIiRiN"i 3NDIiN'P O�1'lIG ATL'R DEPAR7'MGN7', <br /> i:Pl'Y OP E7ERE7'T: <br /> 1 hcreb>• ap!ly (�r Ihc usc of watcr in ace�rdance��'ith thr, ivles and reGula• <br /> �iov of 1'he 1Vatcr 7aparnu�nl, [or purpases aud tistures stated belaw. <br /> Uurin� dic ;ime �hal�my��f Ihe wntr�mains may be taken up by rcasen of <br /> any improvements aulnorized by thc Ci�c n( Gvcrcll.in ur n! an>' strce[ ur alle}' in <br /> �rhich they m,�y have bcen laid, tlm Cit>' �vill nnt bc required to furnish H�ater during <br /> the pn��ress nf such improvements ln anl'consumer �rhose 5����tv mav thus 6e cut <br /> u(f, ur bc liable for ;iny dam;��;es for iK (ailure so tu do. <br /> r\VPlirnUo/n No.'__�� �-_'_"_ <br /> 131ock ... _'-_ �/���N� <br /> (p 3�__' ..._.Lot___"' _ Ad�l.__'. .___ <br /> G �,c� <br /> � ------�--- <br /> \n.Z z /y__._.;._[_''.�:�<6l---°'--'�---_..Strcet <br /> ____'..__'._._ ..____' . "'_""""__"""_"______'___'_' <br /> 'fhc�eork lo be cxecutcd �oy-.___"___""'_ '_____'_'_____""'_ Rlumber ,. <br /> �^I, � / <br /> State vizc��f tap. ���/".•-% <br /> � r ��—V <br /> -'--_� Tap lo be inaerted in Ihe m�in. �� <br /> / __Wmercloset <br /> ._"_'__'.Unlh . <br /> ---'---- .Urinal <br /> . �Y ;�� <br /> ._Plaiu (aucet insidc , � ""4 >�. <br /> ______Sidc�salke•ashcr ,�:,vN . i � �i�;:. <br /> _ � � ( �� ,�. � <br /> �r � C�:t <br /> ________Hosebibuutsidc � ;l � � • � 1 �� <br /> ' �� I� 1 <br /> .__..__hlosebibforhuildingpurpoces i' ', Z.1J: � ' � <br /> ,� , <br /> .._""'_.Hosebibinridc �� � r .. � . : <br /> ,, <br /> __""_"_I4ib(urs[ablecontainiug___..'_-_._�tall ___ -j� �� <br /> � --- 'NumL•cr ot persons in (�unily 7 i <br /> *�* , --- <br /> _".�_Numbcr o(ruoms in 6uilding _ �, . 6� <br /> . . _ <br /> The premises arc to l�c use.� ns a_"_'""_""'___."""______.."" �""" <br /> 'I�hc o���ner o(thc Premises is "__"__._"'__.'______________________""'_"_ <br /> "1'hea8entis .__".____' .._. __'__ _'___" ...__.'.'.____"___.. ____._____' <br /> 'I�his aPPlic�tion,althuut:h signed.shall nol 6c binding upon Ihc CitY. until ao <br /> cepted by The Superintcndent uf the \Vnter Uep. ment. <br /> SiSnc�) .r J� . .� ' r ,'itnCApDlir. t <br /> � ( � � <br /> a -C✓;�_��'.�L . _ _ _' _ __'> !'_'___' <br /> �.� �q i <br /> /� r .,� ,4:=c /1 <br /> '^cepled..._fi7--/.>�__19�S�s. Ry_�'-,i_f",'_'__-_"'_"_"__' <br /> O� — . Sn�'e�inandev <br /> � 1 <br /> G��Zt.t�_�. ' ° � � - . <br />