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, �, <br /> `L._`�e y. N--'�`/(" [.�t�� ��, ,:c �; ;,.� <br /> 1:. J.Porm 4 .1GU0—F..F.Cu.—.',-^_�}nq � <br /> City of Evei�ett�--VvTater llepai�tment <br /> �.��:�ICr'�'I'I�N 1�0I� �TA�'��. <br /> e1ll Llanl.s must Lc filled in or cross-ed o��t <br /> CverMt............._..._`c... ... .. .2:...`�...........1�2.� <br /> 1'O T;f1: SUi'liR?N'iL�DEI�^t OP TiIF�{^���";:P. DEPAI:T?SL\T: <br /> CITY OF 4:�- �:,!;TT: <br /> I hereby anPly fur fhe us� uf waler in :ic,m�d:uce o�i;h tlie rulrs a:�d reCu- <br /> latic��s of the �6';der Department, for pu�po�es :ind fi:;'�.ures stated bdow. <br /> During the timc thu6 any of iho w;iter mnina msy be taken up by rcaeon <br /> of �ny� improvements autLoriced by Lhe City of Gvcrett, in or of any strcet or <br /> nilop in �vliich ihe,r• may I�ace been laid, tne City vill noC be required to furnish <br /> u•ater dm•in� tL� progress .�f sucU impro��ements to any cor.aumer �shosc suPP�.V <br /> m::y thus Ue cut cff, or be GliaUle fur ::n�• demage�s/for its failure so to do. <br /> APplication n'o...._�./.�Z........... � ?i�'1' / l <br /> rioa:. .. ..... 3 � ?-.. 7,�/y H _.. n�}6'? c�°`�,.,�y.._7-�. ,,i ,. . <br /> _.� _.._ . <br /> i <br /> _ _.... <br /> -_. <br /> No. .- ,/..`7�1�-f...p(.GY� .. .-c�yrjt! ._.Street �. <br /> . .. ... ... . .. .. <br /> .._...... _ ......._... <br /> Tlm work to be esecuted by.._ � . . ... ...._. .. - Pimnber <br /> c;t�a�tc size of tap. � o e <br /> _.r,ez....TaP to Ue ir.serteti in thc �nain. /S <br /> �--..�.......�Vater doset <br /> ..._�........Dath . . <br /> ..._�.-..Urinul '�+�� <br /> . <br /> .._z...Pl�in _"uncet insidc <br /> .......'.-.....Sidc u�alk washcr <br /> -��..�........I�Io;c hib out;ide <br /> .-.--.- ..�.Hose bib for building purpos�s <br /> ...._-�...._Hose LiU inside � <br /> ..-'._—....Bib for staLle containin�....._.__........stall.............. <br /> -......�^;_„Numbet' of p�-sons in fnmily <br /> ��_.-�....Numbcr of rooms in buildine <br /> T'.m premises arc to bn used os a._ ._.... ..�(i0_�_. <br /> _.....__.... ... - <br /> :i;_ . <br /> 79�e owner of tl:e premises� is...... . ../�7,z�/C4,��..�_.. <br /> �r,"`'� <br /> Tlie agent is................._............. <br /> .....................__........................................................... <br /> Phis npplicnt;on, nithougli signed, _hn�i not 6e binding upon the City, until <br /> �tc i �y the Superintcr;dcnt of thc Na�er Pepr.rtment. <br /> Sig�ed.........................................................._... L� .... ...!._Applica�t <br /> .... . <br /> ' . ��pp� .__.102� By.. - . <br /> �r�� .. ..... .ef��y�...c / ... � ; <br /> _ _ <br /> / . . ........................... <br /> �-•`�uPerinlenden! . <br /> � <br />