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�;tiea{�� ���- v— �-�—w _r-M;� . ��- � <br /> .. � - � <br /> w. n. Fo�m ♦ isco a-i-i7c.P. <br /> CITY OF EVERETT==Water Department <br /> Application for Water . <br /> All blanka must be tilled in or ossed otu <br /> i <br /> �"��{ s/ <br /> , Grcrelt._. ' "_'_____'_'C_`__''__'__"19i` '_'_' <br /> TO THE SUPI?RINTENUIiId'I'OF �1'IIIi NA'PIiR UL'PARTNF:N7', <br /> CI9'Y OP G`/IiRGTT: <br /> I herehy annl>' tor the use o(�cater in aceordance a�itl� the ndes nnd regula� <br /> tinn;uf The 1Va[er UePartnraul. (ur Purposes anJ li�u�res slated bdme. <br /> During the time Ihat �mp o(�he�vatcr mains map bc taken up bY renson ot <br /> :mr imPruvements auUiorized by the Citp ut Iiverclt.in or uf an}' slrert or aIIeY in <br /> �vhich they mn)' have becn Iaid, thc CiIY ��'ill not bc rcquired tu furnish a•a[cr durin�; <br /> Ihe prngress ol such imprnvemenls tn ;�ny consumer whose supply mm� fhus be cut <br /> oii.ur be li:�ble fur any damaqee fnr i[s (ailure so tn du. <br /> Applienlinn Vn ""_ _" `������ `�" � <br /> �'_'__`' _�[��(�.R��p <br /> Hlock ___"____ '_'__LnL'_'w__�_r�__��'�- eCeld.1__ ..-'__'__"'- <br /> �/J V __' <br /> �n._-/O/-G --'"�"C�ilClio------��---...slrc:t <br /> _.__ ___.__.._'_'_' . ___""__._._ _...__.__.' <br /> 'I'heworktobee>ecutrdb)'._____.__._'__" ._..___. __'.. . _.'__._" Plumber <br /> Slale/.y'�zc n( tap. . <br /> _3!`�-"fap to be inscrted in the main. _� j� a 0 <br /> _� <br /> .____'___.Natcr doset <br /> ._'.__...-13nth , .. � <br /> �. ✓ <br /> __._ ' Cnnai .�...-- `�-t-.�, � <br /> _._ Plain f:mcet inside . .�:1�In` �`�`� ,. . ��� � <br /> .._______Side�calkaashcr ::!•� -�i !' 1 . <br /> ____ r. � 1 l , <br /> .._Hn.c bib nutside - � I. <br /> ._____._..l{osebibforbuildingPurpnses �� : ; � �'� �� <br /> :y, , <br /> __.__"_'lloschibinsidc '� . �� � <br /> '.i_. -'"" . .- . <br /> . __"_"'Ribforstablecontaining_..._...--stall.��:__�t.� '. . <br /> � , �, . __ fi( .:. . . <br /> _..' ___Numbrrof persuns in famill' •,.*.� . <br /> ___'.�___Num6cr o(romn�in bitilding -•, <br /> 'ChePremises�retobcusr<lasa_.__. .__._____.___'_"____'_"""_' '_._" <br /> l'heowneru(thepnmisesis ____'..__"__.____.__._.___'__'_""_______. <br /> Thcagentis .-'-'_'--�---� ------'---'---- �----'-�----�--'--...----------- <br /> '1'Lis applicntiun.allhough signed, shnll not Ue binding upan the CitY. un[il ac <br /> cepted Ly The Superimendent uf the Nnter Depm�tmeut. <br /> 1, ,, <br /> , SiKnrd_I/=�h:..�•___.cC�o'i.c�.•.__ '_'_____ApPlic:ant %, <br /> :\cceptcd.�c-�.�"" -1�/ By . '-• _ <br /> � -__.__-.si:: i�m��x^� <br />