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h/Y7 D 8 --3 1 --7-3 � - - I ^' � ,� 5z �r�s _, � .�,; , <br />+ ��. D.•Form � ISCD 1-i-17C.P. ' � <br />CITY OF EVERETT==Water Department <br />Application for Water <br />All blanks must be filleJ in or crassed nut' <br />yA } <br />Evcrctt..----------'-----'. _ c�//6-----'�-_-�- <br />'CO 'PIIE SUPIiRINTE�UE�T OP'i'IIE NATEIt UEPAItT,11EN9', <br />CIT}' pF F7GRB9'T: <br />1 herehy apply ior the uee n( �v�iter in accord:mcc v: ith thc rules :md regula� <br />tinn: u('Che \Yater Uaparlin �nt. for purposes and fi�tures stated bcluw. <br />Uurin� thc time that any nf thc watrr mains ma�� be tnAen up bY reason of <br />:my imPmvemenis aud�nriaed by Ihr City n( livcrett. in or a( any sireet nr allry in <br />�vhich [hey nmy havc bcen I:�id, tlic l'ib• N'ill nnt 6c required lu lurnish watcr during <br />thc progress n( such improvrmrn[s In any consumcr ���huse supply may thus bc cut <br />off, or bc liablc (n. any dam�igrs for(iJ[s f:+ilure so u� do. <br />Applicntion No."' _". _n. �' d. _D_' _' C <br />I._'._.._'_'.Add�l�ca,^.�. _. . <br />.f <br />_�;i����; _----�-�- Q- -��,�.------ - � -_. _ <br />Vn.---�.��.--�-- ... - - - �(�..Strcet <br />....._.___"' . ."' ' <br />"Phe n�ork to be esecWed bp.-_"""_""".'____"'__"___"'______ Ylumber <br />Slal � sizc u( t:fp. F7 <br />��'__ fap tu Ue insertcd in the main. �. -- -. <br />__'_ �"_'.11'ntcr closrt � <br />_ _. _�. _'. Bath "/ /;_ <br />__.`._ .Urinal <br />_ _..-�_ Plain laumt insidc % ,: <br />.. __ :____Sidc �vnik washer � ' <br />__ �_.._Hn=_cbibuutsi�.lc <br />. __ _"___.linse biU fnr builJing pwposes <br />_. .-.. ___-liasc bib insidc <br />.___' Ribturstnblcrnntainin6�---�--�--.•Iail._.--_--_ <br />__'_ .__.Numbcru(persunsinfamily <br />___�-..._Number nf rooms in 6uilding 'J� <br />'1'hepremisesarea�Leusedasa'._h-�c�:41-:��__..__._ ._ _. <br />Theuwnero(theP�emi,esis ____'. ��-.ClL�-C.<� _ _____.____. <br />_hcagenlis.___'_.__`— .._____ ________ __.__ _.._.."'_____"'_____._ <br />�s :���i��,i;o�,.:aa,����;�< <�r.����, •�„�� n�n n� 6indinR ��Pun thc Citl'. unt ac� <br />�y'Phe Superimendent n( the Vntcr Uepartment. <br />Si' ned � ---ApPlica <br />g j . _. .. . _ _ . . _ __. __.. '___ <br />ee�ned .�_ '____'_191 y_'_'_"' '_'_"'"- . -' <br />. � . Sarerlmenaem <br />