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c .+��F_3:t�-�r. . . . ^. .,: , ; _ ,o., ..i <br />... ;:,no—s.r.co.—s-sc:a <br />�rj of Evei�ett-�Water Depai'' nent <br />� ��'1'�ICATION FOR WATER <br />All Ulnnks must Uc fiiled in or crossed out <br />�veretL ...........................��-................................1 J2.-��.. <br />TO TIiE SUYERINTGNDE+�CLTY OR liVE 2GTT;nCPARTDiLNT: <br />I hereby n��pl�• fer the use of wnter in accord�nce �cith thc rules �md regu- <br />lutions of the �Putcr Dcpnrtment, for pm'po'es �ind fix,ures staicd Uela�v. <br />During tLe time that nny o[ the watcr mnins mny 6c laken uP liY renson <br />of nn}' improvements nut2�orized Uy lhe Citg o[ Evcrett, in or oL nny street or <br />ulley in a•hich thep may hn�•c Ucen Inid, thc City will not bc required to furnish <br />�entcr durin�; thc progress ot such imjirovmnenls to miY consumcr whosc supply <br />may thus Lc cut off, o(r�' 6eq1in/6/1e for any dmn��ges for its failure so to do. <br />Applicn:ion No....C3.../ 'i` -2 ..: " 3 O S�j • <br />..... .... .............. <br />IIlock..........�.. /��..:.:.................. Lot....c�-�::_...................... Add.__.._..__........_........___._. <br />No ..............�%.....�J.._�._ �_......_....�.%71G�!,1-.G1:�'.3trect <br />_..__ ............._ .................. ..._................................_.. <br />'Che work ta 6e execute bY.... .. � -.- �4- .:...-....-...--.....Plum6er <br />, � �b.��- / .. <br />Stnte sizc of tnp. ��i- '/✓` i�'' J� � � � � '•. '' <br />�/ .,{ �,,11 l i I �i <br />,r .y....Tnp to Ue 9aserted in thc mm � <br />1.._....R'nter closet FF� ](: O�q' ,'y`;, 7 <br />.. <br />...../..._.... ,�.,�i, <br />..._.-.....vrinnl <br />...�".......Plnin fnucet insidc <br />.....-........Side wnik wnshcr <br />..../........._Hose Uib oulsidc <br />.- �. � <br />c:;s c�� �i�tr�� y�r,nrt �.;��; <br />....................i , <br />...... ....IIose bib for building Purposes <br />......—.....IIuse bib inside <br />....... ...Bib for stnblc contnining ....................stnll.................... <br />_...�,/...-.Numbcr ot persons in fnmily <br />...'X.�.......NumUer o[ rooms in btiilding �, ^ <br />The premises nrc to be used ns ��............_✓�����""`" ........ ..................................... <br />Tlie owner of tl�c Premis is ........... ... � � <br />/� � ... .. .. <br />Thc ngent is.......--..�__. -�i/,�.�.�_l.:LG..�..�.�............_....._...... <br />This applicntion, although signed, shnll not be 6inding upon the City, until <br />nccepteS by the Superinten�i entn ,o,f qie N D� rtment. <br />Sigr,ed.J.:. . G+—.{��!.....��.... ._1..,..._...........Applicnnt <br />�.......... . , <br />',9 �/ � � <br />Accept^_d.......eX...%�:.......19 �... BY... .. .. .�/I!� .......................... <br />,_,�._,y__Sup etintendent <br />