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�C�t� 'rf_ 2-1— ��• �J c n ��� .,_ r, <br /> W. D. Form a I500 d-1-V G.I'. , • . <br /> CITY OF EVERETT==Water Department <br /> Application for Water <br /> AII blanks must be filled in m cros�ed nut <br /> EvcrMt� _----------------L/2..�.------��-�- <br /> TO 'I'HE SUPHRINTENDIiN'P OF 7'lIE 1VA'PIiR DEPARTk1GN7', <br /> l:I'I'1'OF E`iCRGTT: <br /> 1 hereby apply fnr the use of waler in acrnrdance with the mic�and reRuln- <br /> linn;of'1'hc 1Vater Uepartnvnt, (nr purposcs and fixtures slated below. <br /> DurinK thc time thnt any oi the wa:er mains may be tnkrn up by rcasor. o( ' <br /> :un� impruvemenls authorized by thr City nt Evemtl. in or n( any sircet nr allry in <br /> which thry may have been I��id, the Citr will not be mquired tn lurnish wa[er during <br /> �he pro�ress of such impmvemrms to any consumer whase supply ma}� thus be cut <br /> nf(,nr be liable(or any damagc.fur i[s fnilure so to du. <br /> Applicntion Nu._"'__�`�_ _ � ' <br /> `�"/'__ <br /> Iilo<k .---'------ ------Lut-- --_.-'_.Add-----� �---------- - <br /> — <br /> ---- <br /> Nn.___'. _.�_�'.�_�"' ":4-�'Lp' '..Strec� � <br /> ._._'_.__'_..__"' ' __"_'____ _____'._ <br /> _"'._"'_'_"'__"'_""".______ <br /> 'Che work lu be executed hy_________�_Q�L�,p,,.,o—.�_`_._" Plumber <br /> State siu of tap, <br /> • <br /> - . �_.__Tnp tn be inserled in the main. r, � .7 `- <br /> . .__.�._._R'alcrdnset �/ . , � <br /> .-_..�_._Bath <br /> --.. _- .Urinal <br /> -.-______Plain (aucet insidc <br /> .. .__._'_Side walk �cashcr � . <br /> . .__.._41nsc bib uulsidc ' <br /> _._,__._.Ilose bib fnr huildinq purp�scs <br /> ----_""Hnsc biU insidc .� � <br /> ._'__"'_Ilibforclabiecontaining. .. '.._._.stall__. .__... <br /> ---_.-'__'Numbcr ot persuns in fa�nil�. <br /> ---7_____Numbcr of rnoms in 6uilding <br /> '1'hc premises are to lx used as a ---. _--_-_ --_-. _- <br /> ._'..'___.._ .__.-. <br /> 'fhc ow�ncr ol thc Prcmises is ___"' . _"____ _ <br /> . .._-_ __._.___...'___.__. <br /> "Chc agent is ._'""""'.'_'.""""_"__'_ <br /> This application. al[houFh signed.shall nut bc bindinl!�ip�m lhc City� until ao . <br /> ceptcd 6y 7'he Supyerimendent uf the 1Vntrr Uepartment. <br /> --\'rd �M�=CCG^ _1--VQ.�"7✓LL/ .._.4pplicunt <br /> ry <br /> Acceplcu � <br /> � J � b). . _ 7..-,__.�"'..__.._tt_' / <br /> � ' —t- �- ;y � Sv rl�nana.r'i"'/ <br /> ' C,'/ y <br /> i <br />