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. _ - � - r�-a.�- c __n�,.�,�.�-ti.�C � - ?-� - Y e f✓ sv:, <br />i✓ � <br />v:.n w-ma._�:;o-s.eco.-s-xr_s� <br />City of Ev��rett�Water Depaitment <br />APPLI��A'I'ION FOR WATLR <br />A:1 blar,ks must De filled in or cros=ed out <br />Cccrc/t�._..._....Z .�..J.`../.3..'�............ _ ....................102. _... <br />TO TIIS SUPERINTIiiQDENT OIP TI3E �VATGR DGPAP.TN�N'C: <br />C1TY' OF BVF.P.GTT: <br />1 hereSy aPP�Y for the us'e of �rater in . cecrdance tcith the rules :ir.d regu- <br />Inlion� ci the R'ater Departn;ent, Cor �im�poses and fixluri`s sLi�ed belon�. <br />During lhc lime that eny of the water n:ains mny be taken nP Ly rcason <br />of aiy improcrmencs aut6orzed Uy thc Ci[y of P.vcrett, in or af any strect or <br />alley in �chich �iiey may hara bcen laid, the City will not Ue required to furniah <br />�cuter durinR �he pngres= o` such imProcements to nny consumer ��hose supPly <br />muy tlms bc cut oft, o(r�bc pl�iabf for :u�y dumnSes for its failure so lo do. <br />Applicatio� 'Qo -3.l .4. b . -..... <br />Bluck p._ -. ,�� -_ Lrt ..___r.1 ..� P. Add....___�. ........_...._._.. <br />1 I.. <br />No_ c/.�.��! _.�°"�._. ....._8trect <br />� . ..._........._......._......_... <br />....._.._......_. __........__ _...__..........._ ___..._ ....................._..._...... <br />Tnc ���urL- to be eci„uled 6y_.. _.._... ./�1...... �._i- _. -_._.....Plumbcr <br />.�... -� /' ,,... <br />State sizc of tap. � �� �� -� � � _ <br />n y_...TnP to be iiiserted in the m.^.in. �i(/1 �' . � � <br />__,�.._....R'nler clnseL <br />...� _...._..Bnth <br />_...L......Urinnl <br />...�-.._....Plain fntr.:ct inside <br />.._L......Side �enik w:�shcr <br />..._�.........IIose UiU outside ' �-� <br />..._�:.....IIose bib for building ]iurposes . � <br />... �......Fiosc bib insidc <br />L � <br />.........._....B�b for staLlc contnmmg ....................atall......_......_... <br />... �..--.....Numbcr uf persuns ir. fnmily <br />.. .. Number of rooms in buildin�; yl _ <br />Tlie Ptemises arc to 6c used as n/ 0'1-�/l-� --- K--- -- ���-� <br />Tlie owner of LUe premises is ���....�, b.- .. �... -.. .- ... <br />The agc.�t is.._ ...................... / .... .... <br />...... . . .... ....... ._.... <br />Tliis application, althouqh igned, ahall not be Ui � g upon ' e City, until <br />accepted b;; the Superinten t of 4he R'�3�7ep�t. .� <br />.,.e.,�...�.`/y....._.,...._... ..� _...G� __ ! <br />Accepted..�._.si � 2...... IIY....._. ......................._i <br />l..'f...._.�. , /...... <br />y�l,� �i �Superihtendent y <br />