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� i�� , r/.- • <br />�U. D. Form � I500 ]-1-17 �, p, <br />CITY OF EVERETT==Water Departmeni <br />Application for WQater • <br />dll blanks ntu�s[ br filled/ in o� tmc�se'd m�f� n <br />Ercrctt�._._-"`•'/' �,G((J—Gt. ___'_____191L"Y-� <br />�U . . ____.____' <br />TO THE SUPIiRINTIiNUliN7' OR Til}%\y,\'1'IiI: DF,PARTn1L•'NT, <br />CI'1'Y (Y� EVI:RGTT: <br />1 hen�i�p �pply fur the u,e o( �cater in ;iccardanec with Ihe rules nnd reFula- <br />tinns uf 'Phe 1Vater Uzparlma�rt. !nr purpnscs and fixtures stated beluw, � <br />Uuring tlie time that :my ui the water nmins ntay be taken up by reason o( <br />anp impruvemcnts authorizecl bc Ihc Ciry n( E��crett, in o. o( nm� slreM nr allry in <br />�:hioh Ihey mal' have been laid. thi� Ciq� will no[ be requircd �o (urnish water durinF <br />the pro�ress n( sucl� improvements In any consumcr n�hnsc snppl}• may �huc bc cut <br />nff. ur Lc liable for any Aamages !or itc failure sa la do. <br />s �f <br />rlpplicnlion Nu.'_'�. <br />) � C_. .'_""'_" <br />131uck ._._�i- ;(_1i_ .._I.oL __-��r- � ` <br />�. 7 2`� \dd'_ '__"' <br />q �, � _._ ___._.__ <br />___.____. <br />Nn..____a-/� [�a=f/-t72.�� <br />_'_'_____""'."'_"___."'_'..Strcc[ <br />- - --- ---n- <br />"1'hc x•ork t�• hc czecutr<I 63'.___� __' ______' ___ <br />-'- '-- ---- j /�h Plumbcr <br />Sta�c v' _e of la C��(,.1/• f- �. �✓/ <br />./�J Tap lo bc inscrtcd in thc main. <br />-.--�__R'ater Clnset <br />--.. __ �_.IIatli <br />__- - .UrinaP <br />-----�-Ylain fauce[ inside <br />.. --_-'-Side-nalk-�casher- -- <br />- - --�__Hose bib owsidc <br />� <br />� <br />----____Ilosc bib forbuilding purpuses <br />. .. _____Ilnsc bib insidc /) <br />-_'__'___Uibfarstablecunlaining______._. slalL'__.___ 1 / <br />----- __Numbcr of persons in family � <br />> <br />---- �"Numbcr o! �noms in Luilcliug /�, <br />'1'he premises are In be used as a__ __'_ __ <br />_ . <br />- -.__.____-_ ___.. <br />'Phc o�cner n( lhe premises is ___ _. ____,_ � GZ <br />Thcagent is..-_"___.._.._'_____'_--. ...�_.� <br />This applicalion, allhough signed, shall not bc bindin� upon Ihc Cil}•, until ac <br />cep�ecl by'Phe Superimend t o ie lVntcr Deparhnenl. <br />SiFned�'�:It��/fX�✓'��- j. <br />// - ---- � ���/7�- �'-'Applicant <br />dcccptecl/.�_-� - // � / <br />,.2g--_ _�'Y �;>'_�'� .Y I ._ <br />n ennter.ceni <br />. .__ __'_""__ <br />� <br />