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�...�V � - � a-i < <, . . �.�`d � - -� Y;� � <br />W. D. Form { I500 d-I-17 C. P. <br />� CITY OF EVERETT�=Water Department <br />Appiication for Water <br />All lilanks must be fi ed in or crossed i <br />Ererett. ... _' �."`„/ II' ____"_ 1� <br />____. __.1'J1'!__.... <br />TO 'I'HE SUPIiRIN7'ENDGN'1' Of';TI WATF.R DF.PAR7'T1IiN7', <br />Cf7'�S F EVGRETT: <br />I hcrehy apply (or thc usr�S! w�ter in accordance wilh ILe rules and regula� <br />tiuns uf The Water Dzpartmrnt. !ur Purposes and fixmres staled 6eluw. <br />UurinR the time �hat am� ni the H•atcr mains mny b<• ;ahen up by reawn of <br />:my impruvemenis authorized by Ihe Ciq� o( Evereu, in nr o( any street or :Jlcy in <br />•.chich they may have 6een laid, the City will not bc requireJ to fumish water during <br />the prupress of such improvcments to any rnnsumrr whose supply nmy Ihus be wt <br />��((, nr be liable (or any dam�ges yyf r its Liilure so tn do. <br />ApPlirntinn No.__ _�� V _ �7 //� �—�- q �% <br />Rlock _------ '_ - Lot---�`.`�.._T� ."A7cl_-. /_.'� / O � <br />_ _ . . """' _' _' <br />Kn..___.__.._' __ _...____"_"."_""'_'_____Sirect <br />___"'____'_.."_"_ . ___."__'___'__'_'_._...__-.___"._____'__"""_ <br />'Phe work In be executed by."'__'__"""_ ____._.._""___'_.__' Plumber <br />Statc� o! tap. <br />.-3�-_Tap tn br inxrted in the main. �/� � <br />____". � _Water clnse[ <br />.-_"_� _.Bath <br />__.____ .Urinal .� . . - <br />i <br />-_.'_'___.Plain taucetinsidc . � . , <br />.-____""Side �ealk washcr . . . <br />..___".'Hnsebiboutside � � .I <br />W <br />_________HosebibtorLuildingpurposes 't,. � ' <br />. .. ___' Hnsc 6ib i�side <br />-."_'_"'f3iL (nr s[ahle con[aining. _. _ _ _'.. _ _ _s�all.. _ _ _"" <br />___ 'Numbcrot persuns in famil�• <br />. --_ �_Nwnbcr n( rnnms in building <br />\ The premises are to be usrd as a _ . _ _ . _ _ _"_ _ _ _. <br />_._"._.....__. .___ .__"' <br />Themvnerotthepremisesis_____.____"___..__ __.__. .._...__.._..__ <br />ThraRentis.___"__' .____'__-'._'__ <br />This application, nl�hough signed. shall not be binding u�m the Ciq•. tmtil ao <br />ted by The Superintendrnl of ih Icr Uepartment. <br />� <br />Signed.._"' _ rn � <br />..._. _ ' _.__"'_'A li nt <br />Aeconed..._- • � <br />� __>��_'._ � liy._ <br />� � . � � -�..��nr'rimm�eem-- <br />