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, <br /> Yi,2.�oc �--."� ' '"� --J � <br /> � _--�-� <br /> K'. 0. Form 4 I500 J-I-1%C.F. <br /> C1TV 0� EVERETT==Water Department <br /> �pplication for 'Wate�r <br /> All I;lanks niust b• fillcd in or crussed ou� . <br /> �i> ��J <br /> Livere�L � 4 l. �r .-------.191�1_--- <br /> �.__'_____ <br /> TO THE SUYL•'RINTfiVDii�'1' F I'HG \VATER Df?Pnirr�rn�', <br /> ' 7'Y OF Ii%BRETT: <br /> 1 hereby applY fnr the use ui�valer in accordance with the �vles and reguLr ' <br /> ii����s o(The�N�[er Ueparnn�nt, for Purpusea .�nd fizb:�:s >tated bdoa�. <br /> Uuring thc time that any uf the watcr mains nmy 6e [aken up by rcasun nt <br /> :mp imprmements authurized by the City nf L•'veret[.in�rt ot aiO' -:trcet ur alley i� <br /> whi�h thry maY have been laiil, dic CitY «'iIl not be required U� Iw ���h waler durin{� <br /> the �rngr�ss o(such improvemen[s t�� ���y�onsunu•r ;rhose su:�pk r.:��� Ihus be cnt <br /> �dt. or bc liablc(or anY danm cs(nr iu .`:�ilure so tn dn. <br /> ///////�O O <br /> Applicn:iun No..__/-_ _' '_'___'___' <br /> Fllnck q'_'_" / LoL_'_'"'__' -.'---,\dd _.._. .-_-._'.- - <br /> \n.. o�GO_ _--O�Ct—C� _. ce�_._.. __..Strcel <br /> . �_ _'.___.' � <br /> __.__' __._.___.___'_ . ___'__ ______.___._.____-'_______-__.__._.__'_..__ . <br /> "fhe work lo be execu[ed bY_' _'_'_"'__'_ .._"'__'__"__-"__ ___ Plumber <br /> 5l:�lc 5 c ut t.�P. � /�l a o <br /> ._ ��'_Pap to be insetted in the main. <br /> _ ___(__\Vatercloset <br /> . �.. � '.._ .. <br /> ___ _J___Iiath `-'� ' - . <br /> }� <br /> _ .Urinal . ' .� <br /> � � ___Plain taucet insidc . ^ ��(� �� �� 1�3�� <br /> i <br /> .._______Side�valk washcr .. �'.. --- `� , <br /> _._._H��sebibnulside - � .����"_� . �.. <br /> ._ ' ._I1osc 6ib (orbuildinF pnrpases (�l'� :. <br /> �, „ �. <br /> Fiosc hib insidc .. f � �. <br /> _._'_'_'__I3ibfnrs[ablecontaining.__'_.-----�talC_.,� / _ ` � ' <br /> ____.. _Numbero(persnnsin (amil)' � �, , .I (�- <br /> _ , ) - <br /> _.____�..�`umber nf rnoms in buildinE l /�i'�/ <br /> ThePremisesaretobeusedasa ____._____"__'_"'.�_""'___'_.__ __._.. <br /> "1'he o.vner uf the prcmises is ____..___'_._._'-_____________"_'_.___'_.___ <br /> Thc a�'ent is.. _._ ------- ---"------"----`------ <br /> This nppliratiun, although signed, shall nut be binding upon thc City, until ao <br /> �epted by '�hc Super.n�cnden of'he Nnter UeparUuenL , <br /> Si{med ___�_-"�'--��---ApPlicant <br /> AceepteJ. �Q____al t22?i IIY��__-___'__'_____"___- <br /> "'-""'- Superintendem <br />