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'� 1 <br /> n ? i �mj_,�_ `� _ , . �,.� ,� <br /> �0...:3 n tf-�13- � -� �.__. � <br /> P:.i'.F'orn:J—tnaO—L.P.Cn.--6�.G-.n <br /> City of �verett�Water Department <br /> Ai��'�LICATIQN �nR. WATER <br /> All blanks must be £illed iu ar cr� .�sed out <br /> � <br /> �vcrett,...:./1"f�t�..!.4...... . �._....�'..�2............._..1p°_.�. <br /> TO TIi� SUPERINTPNDEYT OR T,iE 1VATE)t D�PAP.T:dtiN9': <br /> CITY OP G\'?sI:ETT: <br /> I hereby aPP'Y for the use nI tvater in :.ccerd:mce �cith [he rulus and Tegn- <br /> lations uf thc �Vater DeP<<rtment, £or pu��po=es and fistu;-es st:dcd bclow. <br /> lluring the time that any uf tlic water mnins may be taken up Ly rcason <br /> of any improvements auLl�oriud by the City of Eccrett, in or of any atrect or <br /> alley in n�hich tliey may hace bcen laid, the City tvi11 not bc required to furnish <br /> �sater duri�g thn progress of such intprovemcnts to ciy consumer whose su��,iy <br /> may� tLus bc cnt uff, o Ue li Ule for any dxmugcs Sor iTs fnilure �o to do. <br /> Applic.�tiun A' ...��f..�.��.............. <br /> ��' <br /> L�locl . �._�.`� . �ot ...... .. .. Add.__.. ...............__..__.... <br /> ro,..�,�'�� '�', . . Street <br /> . .. .f./Y+��._ . ..... . _. . .... <br /> ._.___.....__...._.......................__.................✓.. . . ._................ ......................._....... <br /> The worlc to Ue e�ccuted by.... � .. ..�....�.�. _.__-.�Plumber <br /> d_ y� �. �J, <br /> State size of tap. ��,�,-_ ✓✓`�' <br /> _�y....Tap to be inserted in the mnin. � � '� � - f� <br /> ' ; <br /> � I �� � „' � <br /> ( ' �. '� � ., , <br /> .. .�___..Nnter doset I -�� , •� � i <br /> , . . <br /> �. ,,;i � �� ������..,,.. <br /> _..�..........Ba[h i.�. �.�� . . .i ::;�� � <br /> ..._—.-_._ <br /> ..Urinnl ��'�� Or EYEI��C-yYy'{n`iEN 06i ��� <br /> _.. // <br /> ._u_.... Plnin fimcr: inside ..:..._...........%::.................... .... <br /> ._...-..-.....S�dc wn)i: tvashcr ; <br /> __�._........Hose bib outside <br /> ...._.:.......IIosc UiU for Uvilding pm'poue: <br /> .......-.:...._IIose bib ii;side <br /> ..__.-.._...BiU for staUle containing.................._st�ll......._........... <br /> _._.-.-......Numbcr ot persons in family <br /> ......��.�.-.....Numbcr of romns in Uuilding <br /> "''�^ premises arc to Ue used as a..__ ._.�� •. <br /> ......._.__........_._......................... <br /> ..��vncr of tlie Premises is........_. ..__......................_. ..............._......_............_. <br /> .p..........................................................._..........._.........._.._........................... <br /> � � . '.ian, ulthough si�ned, sliall nnt be Uinding unon the City, til <br /> :,uperintendent of lh R ater Depnrtment. <br /> :ed... ...�. ..I.�.f'�`.'�.`:.1�....__.._. . _.... ._... .Applica <br /> �....—��_��j By. � ._. .... ... .. ........ } <br /> / crintendent , <br /> � <br />