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\V.:i. Fcrm a I50o a-1-I]0.F. <br />CITY OF EVERETT==Water Department <br />Appli�ati�� for VE7a�ter <br />:111 Ulanks must he filled in or �mssed �w,q <br />// <br />F,eerelt,. �v-��I '/� - <br />.__'__'_'______'_l _...'___'___19t1_`. <br />Tf) 7'lIE SUPP:ItIN7'EKGEK'I' OF"CHI3 NA7'ER DIPANT�1lN7', <br />CITY OF E`/GRE7'T: <br />1 hereby apply tnr the use o( water in accnrdance with the mles and regula� <br />i i�.�n; n( The Nater Uepartm�:nt, for purposes and fixwres stated belua•. <br />During thc time that any of the ���ater mains may be taken up by rcason u! <br />any improvements authorizecl hy [hr City o( Evcrett, in or of any �,Vee[ nr alley i�. <br />�chich [hey mny hace been I�id, the City wi�� nnt be rcquired to fu:nish water d:vin�.� <br />ihe pro�ress at such imprmemcnts tn any consumer whase sur.ply may thw- !��. ,... <br />a'.7. or 6c liable fnr any�dJam.�gcs fnr i[s Gilu�c sn ro dn. <br />T.ppl iCntinn Nn.. _./_ _ �_ �. � --'-' <br />�ii����:.-p--.�-7_� ����----�'�-3-=�-`� �aa--- ---- <br />- —� <br />\n.""10'2 — .SUeel <br />--'-------."- �----------�----------------------------'---- <br />'Cheworktabcezecutedby__._--.__.___________________________ Plum6cr <br />St:�tc size i�f tnp. <br />_y�Z Tap tv bc in=rricd in thc main. <br />____l'_'Nai��r;.�..��.� . ,���, /�'�i '_ <br />-'_'_/____Bath <br />...._' .Urinal <br />__"'___Plain I.ucri !mi�'r <br />. __-__'.Sidc �c:ill: �vashu� <br />. . _ - _ . _Hose bib oulside <br />__._____Hose bih farbuilding purpuses <br />. _______Hosc 6ib inside <br />__'___."_Bib for stable cuntaining. _.--------stJi__.. __,_, <br />____--___Num6erof persnns in family . <br />___'___"'NwnLer ot raums i�i �uilding <br />Thepremisesaretnb isec �sa...'.---- _.._'______..__ _ .. __. <br />• ___ _. <br />The nwner o( the en : s is __ __. --- <br />___ _'_ _ <br />Theagentis..._._-_._.._._ __. _�'-_"'_. __ '_...____ <br />_�___. <br />"1'his :�pplication, althouqh signed, shall nut bc binding upon thc City, until ao <br />e��d by 1'he Superimendent o��1'yjcr eparlm nt. <br />/N <br />Sipned___.___._'_��__ ._____'_'_______ ___________ApPlicant <br />r:��ptcd. _. __ 191 Hy__ ' -../_. ____'__"_. <br />–�. -., _�- _r.i �J�__ .:,.._,,........... <br />