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,��� i„r <br />�._-D .., =�•�y,-)r. -�^.-t�t:-^� �' r»,, <br />W. �. Fcnn � I500 3-617 C. P. <br />CITY OF EVERCTT==Water Department <br />Application for Water <br />All blanks must bc (�Iled iii or crosscd iml <br />_ — p / <br />livcrett...___. ____"._____ J.. "___b'__"__'191Y __. <br />'CU 'i'FIE SUPI'sKINTCNU1iN'P OP 7'11E \VA"CGR UIiPART\iBN'I', <br />� CI7'Y UP E7IiRGTT: <br />1 here6y applv Cur the use u( �rater in acenrdantt w•iUi the rules and requia- <br />livn: of 'Phe \Vater U�P�rlm mt. (ur purposes anJ firtures staled belon•. <br />Uw'in�; the time tha[ any o( tiic c+ater mains m:�y 6e taken up by rens-on of <br />am� imFrnvemerts authur...ed 6�� lhe City o( Eceretl, in nr of any streM or aIIcY in <br />which [hcy m:�Y ���ve been laid. Ihe City ��'ill not 6e mquired to lurmsh water durinp <br />th^. PruFre�s o( sucl� improvemenis l,� nnS co�uumer �chose supply mny Ihus he wt <br />��;I. nr be Lable fm' anY dam:�ges (or it: tailure so tn do. <br />Applirntion No._'"' G-� S'�'-'-- <br />Bluck .____.-__ <br />�-�---Lnt--- '--------�-- -'---Add-� .................... <br />Nn..�_�-�-- �i,��ei.`_L..i,---�----._'-"-.Strcet <br />l r , . l <br />1. ``.L:"L `'n��\_"���.�1�, �:1."'___""""_'__'__""___"__ <br />' <br />._�.1'heu•arklobeesewtedhy.____"____'___'____.__.__"'.-'__._.__ Plumber <br />sc,� sizr��ti,v ��= n con:icc�ratzm: iiorenf i:�is :_-;-1ic:::ti <br />c� r �;g discounection e;i�i:uut reticc <br />-�---_Tap to Ue inscrrc�i2��e n�a� � . <br />nn�� ir.o ;if�tor lleceroUer let, 19.:3 if �¢tle <br />'"'\Yalcrdox[t0 rilp0 �17]f; 1G 110�� �j� �C cGI:�bOT' lOt� l,' :.� <br />---_-Is,u� o'o�ninod L•y i.�enns of a L.I.D. ;ron -+ . <br />_.__ urinai i:ukilteo 'ilatni• Dis�rict, ^ 1 in .^,uc;: everrc <br />"_' _ <br />_-�i,inrauc�iid�ive�' 0.PD],1Ss:11'i, fur�l�ar :�Grces to pa}� �i�c <br />Ccet of sueli di��eoimc�eticn �o �he pur:5• <br />. _.__'__.Sidewalkwaslier .,.�]Cll]" e�C. <br />. � <br />.__'.._._Hosebibuutside ` �`'_ /Ca� <br />__'______Ilose 6ib for building purpnses � , • <br />.______'_Ilo=cbibinside ' . <br />._""._"Bib tnr stablc cantaininR.'_-._._._!-s[all-_....._'_ <br />____.'_"Numbcra(persansinfnmily � <br />___�_____'\wnbero(ruomsinbuilding�.�� " �� <br />'Chc premisc, are tn bc usrd �s a�J.-�--�^--. =��--Q-�-��--�'_.. _._- ...-.. <br />'PheowneroflheDrcmisesis .__"._.,__' ._ __ - -__ __._ __�.___'_ <br />ThcaHentis._"'____'.__.'_'.'....'___" .____'._'._ __"__. ____'___"" <br />This application, aithough signeJ, shall not bc binding upon thc CitY� until ac- <br />ccpted by 7'he SuperiNendent of the 1Vnler Department. <br />Signed.:lJ���t%'.1/-�1-7---(/�/-�:.`Y:c/?l /1_/____ pPlican� <br />AcccPted. ��""��-�'ry- I�yyY����ATX/ . <br />r�omn�eni <br />��: <br />