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�yL.l_�i.' .. ' - _ . .� /', i <br /> . �1... <br /> � - , . <br /> 'q'. �. Form { I500 d-1-17 C.P. �' • - . � . <br /> CITY OF EVERETT==Water Department <br /> Application for Water <br /> All blanks must bc filled in or croased aut <br /> Everett..___'_'__"'___'__'�!-�L <br /> - --------'19tz-�- <br /> TO 'CHE SUPERIN7'ENDIiN1'OP'PHE\VA1'ER DFPAR7'MEN7', ' <br /> CI'i'Y OP G`JERE7'T: <br /> 1 hercby;q�ply (nr the use n(�raler in :icrnrdance aith the rules and requ:a� <br /> ti�.�ns u(The �Vater Ucp:�rtm�nl. fur purpnses and fixtures stateJ brlon•. <br /> During Uie time that anv uf lhc water mains m:n•bc takcn up by rcason af <br /> :my intprovemenls nuthorized hy the Cin•n!Eeerett, in or of :mr sVicet or allcy in <br /> which they m�y have becn I�iJ. the Ci[y n�ill not bc nquircd to lurnish w�ater during <br /> the pro�;ress nf such improvemenls tn a�q•consumer whuse suppiy may ihus Uc cu[ <br /> ,df.or bc liablc(or any dam;igcs!ur its(ailure so lu<lu. <br /> Applirntion No.'__'_`J_`�O_5__ <br /> Block _-o�o-'Z Lot__ � Add <br /> ----' -'---"--- <br /> ----'------------ <br /> -- <br /> , � , <br /> �a.-'-- ---vi /.�--- '---..Street <br /> ._" '_.�/?'L�-.. <br /> '_"_' "'""_"_'_. . <br /> _"""" <br /> .__..____""'_"_""""_"""_ <br /> ""'_'" <br /> 'fhe wark tu be execute<I by_____.. ._ _Cl�¢„2��'__'___ Plumber <br /> sy.ic�.u.i ar�n�. <br /> /% <br /> T-:-"'_'Pap tn be inscrted in the main. <br /> � �� � S� <br /> ---�____.11'atcrcloset L — <br /> _"t_ [iath . _-' . <br /> '_- i ".•�:. . <br /> '--"--- -Urinal ._.. ..,.w`, . <br /> ' : ' ; ' Y <br /> '-""._ Plain (aucet insidc ��� ',` '�1� '� (I . •,�r . <br /> _ I r <br /> - . '____'_Sidc a�alk washcr - � �'i <br /> •. � " <br /> ----___._Husrbibnutsidc �� I� <br /> 1 <br /> ------..Hose bib (or building purposes F� � <br /> ---- ' ___Hoscbib insidc �, — �C� � <br /> .""'__'Riblorstablecuntaining_'_____ __'stall.__._'_- - � .�..'G. <br /> , : .� ,. . . ; . <br /> "_'__'__NumLerofpersnnsinfamily '- c. .,.. ..-�, �� . <br /> .-�__"Numbcr nt rnnms in building <br /> hc premises are lo be used ns a'_________"_"_" <br /> ...""_"'_'_"... <br /> """ <br /> 1'hc uwncr n(the premises is _____,_ <br /> .._'_____. ._.._'____'________' <br /> _"""'... <br /> Thc ngent is . "------ <br /> �---� ----------'-- <br /> This applicatinn.:dthough signed.shall not bc binding upn❑ thc Cily, unlil ac� <br /> cepled by"fhe Superimendcnt of Uie \Ynte<,e�c���ne/nt. /' �l <br /> Siqned____��C/`[.1._ (_ c�.(!�L�L_//�( C IG� 1 <br /> -- --- ---.. APPhcant/ <br /> _._. - --'--_--- <br /> Accepted.-- _ --- B <br /> � �/ , <br /> - - ---- <br /> �:,�-������a��,-- <br />