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%�:-[ N / 1- . <br />S 1--i i �.� Gi`lTi� /1 3J—:�, <br />• � �- y . I � _. , <br />�.'. D. Form � I 500 d-I-17 C. P. � <br />CIT'Y OF EVERETT==Water Department <br />Application for Water <br />All blanks must bc fillcd in or crocsed out <br />EvcrelL . - -'�--------/",�'.f--2'�-l--. .17I'�. �_. <br />TO '1'l1E SUPIiRIA1TENUliN'I' OP'1'illi 1VA'I'IiR DIiPARTTIHN7'. <br />Q7'P OP fiVERG7'T: <br />I hereb>' :�pplY [��r the use �.�( water in :iccnrdance witli the niles :md rr�ul:i- <br />ti�m; u( TSe 1V:rter D_p:�run �nt, fur purpnscs and fistures stated hcluu•. <br />UurinG the lime dmt any uf thr water mains mny br. taken up by re�vnn uf <br />any imp;ovements aulhorized b>� Ihe City n( (jveroR. in nr n( any s�reet ar al'.y in ' <br />whieh th�ev nnv havc bcen laid, thc Ciq� will not bc rrquired to lurnish wnter durin� <br />Iho pro�ress o( such improvrmcias in any consumrr tthuse suPp�l' may thus Le cut <br />�d4 nr be li:ible for:mp daimiges fur it; Giilure sn to do. <br />Applicntion No.""'�f-�� �- <br />131uck _.�_7-�_'" _ ` , . <br />_._.._1uL___'Jr'.___.._.___._Add-hy,r_r ._ :: <br />9 /. . �_ � ._ <br />.. Nn....__.__ �_j- Strcet <br />'__- -C�_.... <br />'___""' ' _"'""' ... . ..... ......."__'.___'. '""'_ <br />'1'hewnrk�ubeesecutrdbl'..__.____'______ . .. __ Plumber ' <br />SI:IIC SRC .�( l.lr. <br />.�'1. ,_'_Tap [o bc inscrteJ in thc maiu. � <br />.._ �'__'_R'aterclosct P o �} <br />__. �__.'.Bath ' S � G <br />.—.---_ .Urin:d <br />�--'-"__Pl:iin fauce[ insidc <br />.-"_""_Sidc walk w•ashcr <br />"'--.-.._Flnse bib oulsitic <br />"""__'1�losc bib (or building pwpu<i.� . <br />"'-"'___Ilnsc bib insidc �. . <br />� ��1, � . <br />_"'_' _ _"I3ib for ptablc containing. __ _ _. __.'..stalL _ _ ._. <br />_" <br />1 -__ .'__\umbrro(persunsinfamil�. <br />--_�'.'_Numb<r nf rooms in bu!:Jing <br />'1'he premises:�re to be used as a____. __' <br />___'__'__._..__._.._.. __ <br />_.. <br />1'he owncr of tlic premises is _.__... <br />.___'._.... _..__._.__. <br />__'..___"_'-. <br />Thcagentis __..___ <br />.._. __._"._'__"_ '_._._._'__.__� <br />Tiiis applicatiun. altliuugh signed, shall not bc binding upun thc Ciry�, until :�o <br />repd�d b5' The SuUcrintendcnt n( tl �5':it��r�y paruucnt. <br />Sil:nrd�_ . .l_ ss__�"rl.7._�Z��� � <br />- — -- >lic. nt <br />, _ " <br />Aa:eptr<I /vL _ -.. ' fi /� � <br />' -- y'"', - <br />�. . --•----•------------ <br />r• : s.,:-�i,���.��� __ <br />� <br />