Laserfiche WebLink
_ jvf�G - �-- . �i - � ' o r�N o--��y-v�Ge <br /> �' - <br /> �'•. D. Fonn 4 I500 3-I-17 C.P. <br /> GITY Ol� E4'ERETT==Water Dep�artme�it <br /> �p�alicatti�n for `�'�t�� <br /> All L'inks inust bc fillc in or crnsscd �u�• � <br /> L•'vcrett�-��__".'_____.____.___19Y��� .. <br /> / / <br /> '1'O 'PHIi SUPL•'RIN1'E1UlN'P Or 9'HE NATIiR UG7'.AK1'�IEN"f, <br /> CPC1'OP G9PRETT: <br /> I herehy apply (or Btr. use of water i:� a[cord�nce tvi[h Ute rules 1nd reF?�Ia- <br /> tions uf'Cho \Vater Departm•nt. tur pw poses and fixmres sla[ed heiow. <br /> Uurin� die !ime th�ic .ny a(the�vater mains may he taken up by reasnn of <br /> :mv impruvements autliori.;ed Lc Ine Cin�u(Everelt, in nr n( anY slreet nr aliec in <br /> �vhich they m�iy have been lai�!. [i�e City willliu[he reQuircd lu furnish e•ater durin� <br /> che prugress u(;uch impmv�menls to nny consumer �chuse suppl_v may thus be ��.�t <br /> �df, ur be liable(or an,fy-/dajm/.}�.y�s { �'its failure so to Jo. <br /> APplicatinn Ni�. -<�Q-_G (�"'-)_' 2 <br /> �����ti --3�,J "___ o _ '�_'' ''_ �__ 1dd _ _ _._ <br /> - '' ______' ___ <br /> ���/._"�' �� "� ."'___Slrec[ <br /> Nu._"_"_" " "'__"" '__'__"_' <br /> ___________________ . _________..-____._____'___________"____'___.'___ <br /> 7'hewurktnheexecutedby.______'___'_'_ "'__'--_______'___'__ Plumber <br /> SCitc/sy'.c n(tap. <br /> . ./<_.�.'Cap to 6e inscrted in the main. <br /> '�_Waicrdnccl � �� <br /> ¢ <br /> _____.�_.Ba[h � Q % <br /> __..._�'__I'mfaucct-h�sidc ��\ T�� <br /> � <br /> . . '__'._Side-wall;-wx+licr <br /> _.__..�___Ho=_c bib outside <br /> _._______�rt�cr.:TtinF-TmTlrosi� <br /> ____.-___Hmcbibinrdr- � �/ <br /> i <br /> ____.___{3i4�-(.xstabhtcmt:rirftii('-_______sl.II________.._�" <br /> . _ ) Numhcr of pernns in (amily � <br /> .____�`__Numbcr o(ronms in Luilding <br /> 'PheDremisesareto6eusedasa___ _ ____�A___'_rn__,_'_./_ ���,/�-•�--.._____. <br /> 'fhe mvnero(tltePremisesis __���_"^'��*:W ��"'"-�-"""-��� <br /> Thcager.t is .______.__._. _______________ ______.___...__." <br /> 7'his applic:�.tion.al(houph signed, shall not bc binding upnn thc CitY, un[il ao <br /> pted 6y The Superimendcnt o`[hc 1Vatcr Uepartment. <br /> Sil;ned ------ - �- - ------- ---�- � -- ----- --.Appljcant <br /> � / � <br /> � .. / � ., <br /> . . •__.� Y.___ _- , <br /> __1�7`/� D ,/d__ __ �f•"________ ,S° <br /> / __v _ v2`�.�if-aieendrn� � <br /> ' �,. / <br />