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_:E ,,,;->- .r_ , ;- . , ._ � , , ,,, 5 ., =w. �)� <br /> , _ <br /> W. D. Form � 1500 3-1-17 C.R . , <br /> CITY OF EVERETT�=Water Department <br /> Application for Water <br /> ;ll1 blanks must be filled in or crossed nut <br /> r•.vcretc._-�--�-----------�12_. .-------Is��7! <br /> TO 'I'HE SUPERINTF.NUIiN'I'OR'CHE WATER DF.PARTMENT, <br /> CPIY UF EVtiR67'T: <br /> I hrreby applY C��r the use of anter in :�tcnrdance�vith the mles and reFula- <br /> tiuos of The Naler Departm�nl. fur purposes 1nd fiswres stated 6elo�v. <br /> During tlie time �Lat an1'n( the water mains may bc taken up by reason of <br /> ❑nv imPrnvements authorized by the City u(Evcrett,in or of nnY slrcel or alleY in <br /> �vhich[heY ����)'havc bcen IaiJ. the Cih���'ill not be rcquircd tn furnish walcr during <br /> o((,rr be liablc fur'anv�d�nages for i[s failtvessn�tn dohnsc supply may thus be cut <br /> Appiirntian Nu.._7_.[_��-"---' <br /> llock ' Lo[._�__'._'___._.'__Add_..__. ._'._._.___-_ <br /> --['�------' - — <br /> \o._y2.d-��' -- �"--'- -- -"'-.Strcet <br /> -- - — ---- <br /> ----- — -------'-- ---------'--------------- <br /> � _ I'lumber <br /> '1'he work to be e�ecuted by..____.'_'__"'_ _.._____-._--____-___ <br /> Stale sizc u( tap. <br /> �� _'1'ap tn bc roscrted in the main. � � <br /> � / �� /I s�� <br /> __"I_'_Natcr closel /^_ <br /> / <br /> �Rath <br /> .__ .___ .Urinal <br /> .__"'__'.Plain fautttin�ide <br /> .._'_'_'_Sidc�ealk a�asher <br /> _"""'_Ilose bib nutsidc <br /> __""__'llose bib (orbuilding purpn<es <br /> _____"___IlnscUibinsidc � '1 . <br /> __""'_'liib(nrstablecontaininK___'__._.__sLdl.__.._.'_ r: . <br /> _.__-"_'.Numbcr o(persnm in (amily. <br /> __3"_'Number n(roams in building . <br /> '1'he Premises are to be used as a --- -�---� '" <br /> '1'he nn�ner�d[he Premi�es is <br /> __ -__ "___" <br /> ___.._ _' ___� <br /> "" ' _'..__' <br /> __ _' <br /> . ._""""'_ _""'_ '_" <br /> ' _"_"'_'" '_."' <br /> ' Ic .-OI �s ."'_"_"_'-'_ ' <br /> '_ <br /> This npplicatian, although signed.shall not 6e binding upun the Ciq•. until ac <br /> epted 6y The Superin�ende f ilic 15'n[er UcP��'unent. <br /> Sig�ed___ � ._-- - - - __ ._ApPlicanl <br /> -.___."____-__'_"_._, - <br /> �,�,'/ -_� .-__._.____ <br /> Acecptrd��--- -__'._�'�l By � . . �.,imenn�m <br /> ./ <br />