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C'/17 � - a - ,. . - � � , i= � c.i_ <br />_ _ '� - " "' �- <br />w. o. Fo.�, a I500 d-i-17 C. P. ' ' <br />CITY OF EVERETT==Water Departrrient <br />Application for Wates- <br />All blanks must be filled in or crp�s �,��t <br />livcrcu.. ��_' _ _-� _ ._ _ _ _ _' _ _ _ .19� <br />TO THE SUPIiRIN1'ENU1±�7' OF 9'HE WATGR UEPART�7ENT, <br />CiT}' pF EYBRETT: <br />���ife�)' �PP�Y f��r the use n( water in :¢cordnnce w�i[h the rules and rcgula� <br />tion: uf The Water D;parl:n �nq fnr purposes and fixtures staled belnw. <br />UurinK Ihc time Ihat an�� o( the wa[cr mains may be taken up by reason ot <br />any imyirm•ements authorized by (h¢ Ci�v o( Fverett, in or of any sireet ��r alii�y in <br />which they may have becn laid, the C{�y wjp nnt bi rrquired to lurnish u•a(er durin�; <br />the proqress of such imprnvements tn any consumcr whose supply may thns be cut <br />n(f, or bc liablc (or any dam:�Kcs fnr its (ailure sn to do, <br />APPlirntian Nn.--� � �_ � <br />' ""_'_" <br />BIxA `5 _ �.� -y <br />__ __L _ ._'/-.._ Add____ <br />� <br />. <br />-y�� Q ' / .._-___._____ <br />10..__ _' _' ' _Strcet <br />-./'d �f'_____'_' . _'__..._ <br />'fhe w�ork to be excculed 65 -__.___'___' '._______'_ '_"_'____ Plumber <br />State /sy'�e nf tap, <br />._J__�.7'ap [o be insened in the main. .� /� U� <br />� <br />_ __ _"�. _ Water cl�vset <br />_.' _. __.13a0� <br />__..__ _Urinal <br />__.l.__Plain (auret insidc <br />.-_-_._.._Sidc walk washcr <br />_ . _ _ . _ _ . _ Husc bib nutsidc <br />.. _ _ _ _ _ . _ _ Ho¢e bib (nr build ing pw-pnscs - <br />. _ - _ _ _ . _. _ Hnse bih insidc <br />..'_" _--Bibfarsla6lecantaininq________stall��J'`__' <br />. _. _.Numbcr of prrsuns in lamily � <br />.__a_. 'l <br />_'_._Numbcr o( ronms in 6uilding <br />The premises arc lo bc used as � _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />__._-___'.___' _'_._. <br />- Thenw•nerofiheprrmisesis.___..___,____,___ <br />_..___.__. _______".__. <br />The agen� is . _' _ _ _ _ _ _ <br />.._____.________' ._ <br />This applicalinn. althou�!h d h•,,,yyy���I t mdin �pon e Cily, until ac <br />� .��` by The SuperiNende���r U rnnrn� <br />Signed _ _''-_' � � ir / /K/!�� / / <br />___ ___.__.. _ .___ ___ <br />.7-'-/.�-F---- �// 13y.___ _ �. . <br />--7 - - �:n���e�.,�.. <br />