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L nil� S-2y-za a( <br />�,; n � ?. . <br />�..Ti/� • ' ' <br />' � � W. fl. Forn � I500 YI- V C. 7. <br />CITY 0� EVERETT==Water Department <br />Application for Wa�er <br />All blanks must 1• filled in or crocsc)d o/ut�� / ,� <br />. '�/��j L✓ ����/�) <br />Evcreu.._._'__ _ fL_'Y___:"_"'__'_I'J�Y"-�,- <br />'f0 1'HE SUPF.RIN1'ENDIiN7' OI� 1'IIG �YATER DEPARTMBNT, <br />CIT1" OF E`IERETT: <br />1 herehy applY (�r the use u( �viter in accordance n•ith the rules and regula- <br />tiuns of The Nater D:partmenl, tor puqios�s and fix[ures stnted below. <br />Uuring Ihe time that :mv ��I the water mains mny bc tnken up by reason ot <br />:my improvemenls authorizcei bp the Cily of 6veretl, in or nf nn)• strcet nr alley in <br />whidi [hey ma5' have bcen laid, tLe CitS' ��•ill not bc required to (urnish water during <br />die prnFress n( such imprmemen[s tn any rnnsumer whnse supp�Y may Ihus he cut <br />nf(. or be liable for:m}' d���ge+���s f�ilure so [o do. <br />/ <br />Applirntion Nn. _ _'���a /� ,�j ��`'/ <br />"_". _" <br />Blnck� -. _" __ __Li _. _:/__r��-..�\dd.'�:_"�___'__`:"`"`� <br />, O <br />\a"'_'��v�.�'__' "'_"""'_""""' Stfec[ <br />'""'_'""__'__"___'""" ' __"__'______"__'_'_'"'__"""__"____'__'_""_"'_____'"__'_" <br />'1'he work lo be executed by...___._'___""...__.__-__'_._-_._.__'__ Plumber <br />Statc s e nf tap. <br />_��_TaP to bc inserted in the main. - <br />____ / __N�tcrdoset <br />_ � <br />.__'�_.13atlt �i <br />--_ _" .Urinal <br />'- '-" __Pl.iin fauret insidc � <br />___Sidc walk washer <br />_._Hose bi6 uutsidc <br />_ _ _'_' _"_Hosc bib fnr 6uilding purposes <br />-_.___"__I{nse bib insiJc <br />_ _"_' _"_Rib for s[ablc conlaining. __ _. __' ---- <br />_ _ Numbr: of persunx in (amil}' <br />___�__Numberof rouins in building <br />The Premises are [o be us��J as a_.. _.. ________'__"'_"'_"_""'____ '_"'. <br />7'he mvner nf Ihe Vremists is _""'-__'__"_' __-_""'"""__""__"__"_ <br />Thcngen[is .._--__'___"__.__'_ _-___"""___..___________' <br />This npDlicalinn, althocgh signcJ, shall not bc 6inding upm� the City, un�il ac <br />� <br />cep[ed by The Superimende o hc 1+V�n/`r.r epnruue�� —� �� <br />Signed,�Y.l.��.-_.__ _ 1__"""ApPlicant <br />/ <br />AC[ep�ed ...�-�{�e-Y.-��i) I�q.`^Gir�_'"".SuOer�men.'.em <br />