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r� ,ai_,_t�, 1) -<l-- "+_ �I f'c'•.� ,, �-r�-l_i_'wct �U. 'Y L - 1.(s Y�, �. �. <br />\V. D. F'orm S—�IfOD--EB.Co.—G ".C-:C <br />City of Evei�ett�Z�l�ter Department <br />APPLICATION FOR W�.TER <br />All Llanl:s must Lc filled in or crossed out <br />Ev e rc ts � ................... _............... _.... _............... _... _... _. _ 1 s 2...... <br />'CO TIIB SUPEI2INTF.A`D�NT OP TiIG R'ATGR UEI':11:T\I�\'C: <br />CITT OR liVli1:CTT: <br />1 hereLy npp;y tor t!�e ns_ �t «•aler in accnrd:mce �vith the rules cnd mgu- <br />lutions of the Nntcr Depa-:.neut, for purposes and fix'ures stetc<I bcta�a. <br />lluring Uie timc tliat 1r.y of tlic �vatcr mnins mny Uc tnken up hy rimson <br />ot any ir:proeement� auth�n�zed bp the City� of licerett, in or of �ny strcet or <br />alley in �cl�ich they mnp h^��e bcen laid, the City o�ill not be required to furnisli <br />water during the prugresa n: such imP*ovements to nny consumer whose sup�ily <br />may thus 6e cut off, or b�e) liable fo(�r any damages for its failure so to da. <br />ApplicntionNo........._.P..:S..�...d.......... ��,�h���"`�'� <br />Block................_............_....._. Lot.......�._Z_............ .. Ad .. ..___._..._. _._...._..�/. _ . . <br />x�..l.,2.0..-�-�-J-��,u.1.�-�.e,�.--.i�s��� ,� c V 1, <br />_.... . _..... __.........._............_ ................ _._ ._ ....._..............__ . ._. _ _........................ <br />TLe work to be executed by.._.__.._._... _ ..__........___..__ ........... ......Plumber <br />Sln c s�ze of tnp. <br />� :' ':i�is nPPlica�.io.. ? : �rac <br />1�:.!....Tnp to bc inscrted in thc ronin. �� ..�� iC1' ':;t� ills'Gct11;;ti_G:: <br />' :nd ior <br />.._............A'nter closet Oi ❑ CO .:.C�1Ci: �...�_ <br />. . � <br />—� r::�d ior �;:e rcc or �:....:. <br />................[3nch . �..e��er <br />................Urinal —1'atiai. 7 iur�::er c�roe -:: <br />.. a:j� c:ei;iz:::ua; o f ; 3•00 _ e r <br />................Plnin fnucet ms�de� . - . . . <br />i.:G:lull 0'.: '�+:1£ ::.Cyi.dI'OC CGil': GC- <br />................5iJc walk n�nsher : . ,,, . . <br />, , �lOtl �.. ..L;i'C e; upqri o^ ::.e <br />................Hasc bib o�tsidc. � �i�" CoU:1::i1 �- '.:4C1'C�'�. <br />................Aosc Uib for building purp�ses .�.. Lp� ,��_ I p ao <br />b _ <br />................iIosc biU insidc � � %r�r [-.c.._._ 3p �— <br />................Bib for stablc cw�tninidF....................stall.................._ �. <br />................Numbcr o[ persons in tnmily <br />.................rumLcr of romns in building p� _ �� -• <br />The Premises nre to bc used us /q�,_. .'%L�"Q�'��A-�/--�.�-�-{'.........Q. <br />Thc o��•ner of t6e prcciises ig,(.-.Q-cr-:ya..../'�-�.-:eti2.-�L.'..�......—.... <br />! <br />Thcageut is ............................_.........................._......._......._..._......_............................. <br />This npplicntion, ulthou�L =iGned, sLnll nol bc 6indirg upon tl�c Ciry, IDitil <br />cccePted by the Superintendent oC the Wuter Depnrhnenl. <br />5igned...f.�:-:,._: � .................................................... .:............ ......Applicnnt <br />Accepted.....,.�.....�....��.�.....Y..........192(/. Iiy.��i��.�.� � . ............ <br />�uperintendent <br />