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I; <br />+ (. .. . _ ' �. .. ..F N'r �! S -'2 �! _.�: 3 _J>_: <br />H'. D. Porm a�.500 Y4 V G. p. <br />CITY OF EVERETT==Wate'r Department <br />Application f.or Water <br />.411 blanks must be filled in or crossed nut <br />E�•erett..________'_ ���r_i�'_ 14�..'._ <br />TO THE SUPIinItiTEnDGN�1' OF'fHfi NATER DEPqRTA7ENT, <br />CI7'1' OR EYggtiTT: <br />1 hereby app1Y (nr the use n( water in accordnnce with Ihe rules and regula� <br />�inns uf The 1Vater Uepartm �nt, (or purposes :md fistures stated below. <br />During the lime thai :my ui Ihe water m�ins inay bc taken up by reason of <br />:IDy intpruve�rrnts authurized by the Ciq� uf Iiverett, in or uf any strcet or allcy in <br />which [hry may have been IaiA, the Gtr �rill mrt be reGuired to furnish watcr durin� <br />the pra�;ress of such improrements la :my consumer w�hose supply may thus 6c cut <br />-i(f, or 6c liablc for :my damag/es (nr its failurc ..o to do. <br />APPlicntion Na._l__� � �4'_. ___ _ _. r <br />�J � _ ) ._ . . ° ;� <br />Hlock.---v--- --- Loi._._.•_( _.�'�— / . : � <br />� __ p -.._'_.Add.. `;._:...._.__._ <br />Nn..__�_�.Z f.._�i�R'evt-oC._'."'_'..Stree(' .__. <br />___'.___'_.___"' . ____"__....___._.'__._"'_'_'__._"_"_'_'_""""_'. <br />'fhe wmk in be rzecuted hy._____"_'__"'_'_'___'___.______._ Plumber <br />Stale s r o! Inp. � . <br />/ <br />---- --�' Tap to be inserlcd in the main. ��i <br />"-""'_"Watcrclasrt� �eS � <br />__"'.__.IIatU � �_ <br />-_. _ _ .Urin:�l � � <br />. - -. ___Plain faucet insidc � '�,,, <br />-----__Side aalk washer � <br />. _.___. "pnse bib nutside <br />---_"_._FtusebibinrbuildiqCP����P���es . �` <br />. . - - _ _ _ _ _. Hosc bib inside <br />_.._'_'_.._6ib (orstablc cantaining._'_'___....slall.l• _.�' ' <br />—_--__'Numbcr nt persons in GmilY � ' I <br />--�'_Number nf rooms in building . <br />'I'he premises are to be usvd as a'._' __ � . <br />_ _ _ __'__""' '_"-' <br />7'heo�cnerufthepremise=is___'_� �. _,�r��u{�� <br />_ •. _ - ________ <br />_""_",_ <br />Thea�entis__'_'____'_'._" """"" <br />7'his applicatinn, allhnugh signed. shall not be binding u• ^ th¢ CiIY, until ac. . <br />cepled 6y The Superimendent o( the Wn[er UcUgtment. <br />' �� �' � - � ��/' �% <br />Sixned____.'`�L..-__._�-_!�i/d�l/ � �_______Applican[ <br />Acccnted V�--= ' � 111=`� B "' .�-�� - . <br />�^- -- r_F,=='7�y--- <br />------ ;�.; .;� ----- <br />.,1 Intendem <br />�� <br />