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CN �T-'i�—?-`�".' <br />W. 0. Form 4 t�i( 0 J-I.17 C. P. <br />CITY OF EVERETT-=Water Department <br />Application for W/aJter <br />All blanks must be filled ' or crosse� <br />Evcrett.- ���-__. ___'__ _"_19Y_ ¢'_ <br />�r � <br />TO THE SUPF.RINTENDF.N'1' OF TliE WATER DEPARTMERT, <br />CITY nF GVERETT: <br />: h_:elw apply tor the use f water in accordance wi[h thc rules and reguia• <br />ti:ms ��('fh� \Va�er Daparnnc.u, R.rc nnrposes and fixmres stnted below. <br />Uuring tim tim • th�tt am� ..` [he water mains may be [aken up 6y rcason of <br />any i�iprnvements authurized 6p tne City of Ecerel[, in or ot any strcet or alley in <br />wl�ich .hey m��y have heen laid, the City wili nnt he requimd to Nmish water during <br />the progress n( such impruvements tn any consumer whose supply may thus be cut <br />nif, m 6e liable tor any da�m7agreJs (or its fnilure so to do. <br />AnPlia�tion No.--� / _ ( .�---' -ry <br />Illuck .--'�.�!'�' --- 't ��+-- "--'-. Add---•'.--."'—"--- <br />�"--��e�-•1- ��--- --'-'-."_ Street <br />' ' - -'--.. . -- -""--� ---.--- <br />'fhr �orktobrexecutedbY.____."'L.�-"____'_____"""_ Plumber <br />St �v/e��z e of tap. <br />/- �-? <br />_ ."1'ap to be inserted in [he main. <br />__. �_.Waierclnse[ <br />._"'�'-Bath <br />—.. -'- ,llrixe#-- <br />. _ _ . _ /. _ - Plain taucet inside <br />� /� � <br />� % <br />i / ; <br />- - ,�-� P�� � <br />_ s��SiAemalliwasTier / �J <br />A /I� � <br />_ _ _ _.t"._Hose bib outside � , / <br />-��--'---�-Ia..¢eti��.�...�.,.�u:nH-W�r _ � � <br />____'__ <br />__Hnerbib�ms�A€' -�/ : . <br />i . � <br />Hib-fer�taMern7ltani"inQ.'________' talJ._��'_"�: <br />_�_Number nf persnns in family <br />____�___Number ot rooms in Uuildin - <br />The premises are [n be used as a . _ _ _ _ __ _ �i�„ <br />The owner of the premises is _. __.'_________ __________ �Sl ___.__._____ <br />"CheaNentis _"'____"._._""_'_'__"" ____._"'..""'. <br />7'his npplicatinn, although siNned, shall not bc bindinq upon tl�e City, until ao <br />�tcd bp The Superin�enden ot the Weter D artment. <br />SiQned _�,1�_�Cx<'___�C���.:Q��C��G/_/S__Applic. <br />Accepte�l.�� -��'�..�_1lP.3 i`SIi��%:��J-.--'�i-/ <br />