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_ .r- . � .�.� f.Yjy7_> _. ; . _ - -- .-i , <br /> .� ♦ - <br /> W. D. Fprm { I5G0 d-I-17 C.P. ' <br /> CITY OF EVERETT==Water Department <br /> �� Application for Water <br /> , � <br /> ` ' � • � . . ' ,. � All blanks nmst be ftlled in or crossed aut <br /> . Gverett..-"'.--_'-�..'--'-�-'U��---'---191 "ll- <br /> TO 7'HE SUPERINTENUIiN7'OR THE WATF.R DEPARTMGN'P. <br /> C17'1'OF' E`IERGTT: <br /> 1 here6y apply for the use of�ealcr in rcordance e�ith ihe rules and requl:r <br /> tiu�; n('Phe �Yater UaparUiunt, (nr purpnses , iJ �xmres st�ted below. <br /> During tlie time that :un•oi the watcr mains may he taken up by reasan n( <br /> :mp imprnvemenls authorized by tiie City uf Hverett, in or of any strcel nr alley in <br /> ���hich Ih^y m�Y havc becn L�id. the City�eill not be reqi�ired to lurnish watcr during <br /> lh•: pio{;resa uf 9uch Improventen(s tn anv rnnsumer whotttt supply m�y �hus be cut <br /> nl(, ur bc liablc for anp dam;iges fnr it;failure su lo du. <br /> :1Pplirntinn No.'_' '_"'. O <br /> ��__'__.__' / <br /> 131ocA .__3--"�..g --�`-- S-y`---..Add----- <br /> ___.. _ <br /> �__ _._"_"___-_ <br /> . /G/_t� <br /> \n._. _ __._ "___"___'.'__". Street <br /> .__._'_______.___"' . _-__'_____--. . <br /> •'Che wurk tn be esecutecl by._. ^-��7 Plumber <br /> "'__' '_ __"_"__"__' <br /> Stat�e�;ize n( [ap. ���-- <br /> . .-:/.7�Tap tn be inscrted in ihe main. �' O � � S% <br /> _____'�_Watercloset ' � —'- <br /> __._'�..I3ath <br /> "" .___ .Urinal - <br /> .�. <br /> _""'____Plain fnucet insidc ._. <br /> � � <br /> ._________Sidc�c:Jk washcr .�� � ,� . � <br /> "'_'___._I lusc bib out,idc <br /> "'_'__'_Hosc bib forbuilding purpoves . . <br /> """""Hosc bib insidc ... <br /> � .""'."_[ii6(orsla6lecuntaining.____'...___stall____.__ <br /> I�� ._'_..i umbrruf persunsin tamily <br /> i <br /> .. H. .___�`l"'NumLcr of rooms in buJding <br /> i .".r . <br /> � l'he premises am tn be used ns a' __.'___..."'___""._'_"""""" "_"' <br /> 1'heowneruf[hepremisesis "'__ __"__'_._'_'_,_________,_'_ <br /> _""""'_" <br /> ;� r��, :hengentis""_"'__""_""'""""'_"" ""_"_"""'"_'__"____"'_' <br /> 1:1 <br /> r �._�,; � 7'his applicalinn, althougl� signed,shall �ot be binding upon Ihc City, tmtil ao <br /> � , `� oel�;�"1 by The Superintendent n(tlte 1 eye.U�parlmcnt. <br /> . �.:1 — <br /> Signed_F'�J-----"--- -'---_--'---- / A��plicant / <br /> -'----" <br /> :�«�P«a.��f"___�?�,',_�sG nY-.%r- —Y- - ---- <br /> �ur•�+�tendm� <br /> i <br />