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��9. . - . . . . _ .� , y . .. -. <br />N. D. Fo�m � I500 3-1- V C. P. <br />CITV OF- EVERETT==lVater Department <br />A�plication for Water <br />AII 6lanks must bc filled in or crossed out <br />F,.��M�..------------------'J� 5-----��_/— <br />'I'O 'CIf E SUPIiRINTL'NUliV7' OP THIi 1VATIiR DL'i'AR7'118KT, <br />CI'1'1' O� G`/ERETT: <br />I hrreby aPPIy fnr the nse a( �eater in accordance with ihe rules and regula- <br />ti�.cis of '1'he \\'ater Dapartment. fnr VurP����'s and tixtures stated bclocr. <br />Durinq thr timc Ihat any ni thr watcr mains mar hr tnken ��p by rcason ot <br />:mp imPrnvements aulhorized hq the Ciry• of lireretl, in ur of an)' strcct or alle3' in <br />���hich Uiry nny have beeu laid. the City will not be rcquireA to lurnish wa[er during <br />the prntiress of such impruveinents to any coiisumer w�ho>e suPPl}• m:p� thus be cut <br />n(i, ur be liable for any damages for it; (ailure sn In du. <br />Al�plin�linn No."' _' / n.�. Q ' _" <br />Rluck �s2--,a-_" .-'_'LuI-L_���:"�Zc�s�..� \dd---_-____'_'__'__ <br />\a."'." __'_ �C Q.� 0_""�Q} '"�_. -�J "5trcet <br />__.._.__._._.____' ' __.______. <br />- (V- ------------- �__.__________'________' <br />'1'hc�curklobecxecuted6y .- .__.._.__.__ .__._____..... -_.-_'_ Plumbcr <br />�tc sizr uf tap. <br />j Pap to Uc in.erled in the main. , <br />___�� \1'atcrclasrt p O <br />I-- .. t;��,, 3 5 �' <br />, <br />- -. ur��,i �. .:.,_`. '; <br />_._._.._Plainfaucctinsidc � _ --'. ���:� '� <br />�� � '\ . �� <br />. ____Sidc ��a16 �cashcr � �\'� � .� �� � <br />._Hu=cbiboutsidc \��� "' � il`.,1 <br />r �{d �}' �y <br />_ __Hose bib (nrbuilding purpn es ���. �.i'� .. ,-� ��\.� �. ; <br />. _ "'llu=.c bib insidc `: �, � _ �� r : L r, <br />v^ <br />_ ' _.___Ilibfnrstablecuntaining_ _��11`v'4e��''���ee� ���� 1��! ,��..s <br />... _'NumbcrofPcrsonsin(amil)' yG�b�L-�r�. <br />___/�.�_Numbcr n( roonv. in building <br />The Premises are lo bc used as a_.__ .--_.__.___.._."""""'__.____ '_-'_. <br />"I'he uwner ot the premises ic ._"_._.-___._'.'..--.___'____'.'_______'_.___-_ <br />"I'hcaFentis '___. .____..________'.-_.._._______'_'-.____"_.__'_ <br />'Chis npplicalinn, althnutih signed, shall nut be binding upnu the Ciq', un[il ac- <br />c:plcd b}' 7'he SuP�rintcndent +( the 1lhdcr I� P�rui ent� � <br />$ignrd . _ _ ��,.a�%�� . _ _�PPlicant <br />dcn�pred_�_ '".:_� ._IJl"/ Rp:%.'" _ �.:;"___.... __'__'_"'_ � <br />. . _. � - , � J:q+rintenAem <br />