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�iri 1._7-xs-zr� : ,v-ry, 6-i2-�3 ,H7 <br />W. D. Fo�m � I500 J-b 17 G. P. <br />CITY OF EVERCTT==Water Department <br />Ap}�lication for Water <br />All blanAs must be filled in or cravsed uut <br />L'vcrctt. -._ �/�,�--__"_'__19Y�_. <br />'PO THL•' SUPIiHIN"1'GNDIiN7' OI� 7'IIIi �VA'I'ER DIiPAlt7'n1IiNT. <br />l'1'fl' OF IiYLRE7'T: <br />1 hereby apPly (or the use of water in accurdance ��•ith the ndes and regula� . <br />tions o('Che 1Vater D;p:�rtm mt. (ur ���urposes aud fixtures st:ited Lelou�. � <br />Uurirq the time tha[ any oi the w•atcr mains m�y bc t:�ken up hy renson o( <br />nnv imPruvi•ments :mthorized br li�<• Ci�y n( liverelt. in or of any �Veel �rc alley in . <br />�vhich they in'�)' have becn I;iid. [he City a•i�l not 6c rcquired ta furnish waler during <br />tLc proxmss ut sueh improvemcnts tn any cnnsumrr ���husc supply m:�y thus bc cut <br />n(( or bc 1ia61c fnr :m5 ��r.iaKes qfor il� Liilure so to du. <br />Applicntinn Nn.""' �- �,..! _ Z"_ __ �,� �� � <br />I31uck.___'-' ' _ 1.mc�-L'�'.'_' Ad�//a-�-S- <br />"_ _ _- <br />t/� _, � A�, y. ` <br />_____ <br />\n._ � T�-'.-:_/_l�U � 1 �t'� '.' �''"iL _'_'_Z4Street �- , <br />l_ _� l 1 <br />-' — - -- -- i: '/0_19/o.-3S�_- 1--- �` ��_� <br />`� _____; __. Plumber <br />'fhe�vorktohcececure<Ihy...__�.�'�.� ' ___-___'_... <br />State sizc uf tap. •'� fl C011:'1::01'fl �:.011 i101'OOI' 'o�:lU 7Li;�� li?ili'. <br />1�,( co, nei �� �o ::iscounection ciz;:ou� no�ico <br />3_+'---'-Tep tn bc rosertec� iq t��c wa�µ.y �� i �'� <br />o.ir; �.nic cti �or � acemoor lat, 19::3 if ti„lc <br />" '�^1Vatcrdosel<� ..�:n _ ,')� 1111� l:i i10�'i,� �:iq Dcca:.:hux• 1:,-;,, . <br />-- ---- u,u, �.,� ,�, �,.::.°:nod �; n.n::� o' c ?,.I.D. rru:.i <br />.Orinal ��u1:i�tr,0 C,'a:el' Dictl'lc'c� anu iri :Uch Ovwti, <br />— _t�i,un t,ucei iiisieico up, liceu� CurP.;i::- at;reus to pay tho <br />----.---sidc �e,lk wne�o�;t o i ..idh c_.: =°:_.,e^iiou to 'a;:e ;'a'• �Y <br />:'._�}:in s .,c. <br />.._�._.'..Hu=ehiboutside �/ � ,�CC ,, _ _ L <br />. � n'_.r`"�' , <br />`—� _Ilusc bib for building purpoxs V � <br />---- �S-_a <br />___—_'__Hnsc bib insidc '� <br />13iU (or stablc containing._ _ _ _'_. _ _-slail. -_. ... -�� . <br />_ �_-�-..__"NumLcrof Persnus in family \: i <br />-rNumbcr o( nmms in building �' 1 � . <br />---- r,.�.G���� • ' � <br />'fhe Premises are to be uscd as a_. .' _' _..' ". S:._' _____' <br />'1'he u�cner o( Ihe premiscs is _ _ _ "� �... � �u� �: / '-�,�.n. _' _ . _ _ _ _ _ <br />d`` '_ <br />'fhcagenlis."'_'_' ( '�__�"__"".__-"_'-'"" <br />; his app�:..�tion, althm�Fh sigrcd, sh�li not bc binding upun thc Cit>'. until ac- <br />. by Thr Superin�endent o( th 1Vnter lleparlmrnt. <br />� Si�ned__.__.._'_�-`--'����� li•' �___.'_____'ApPlicant � . :. �: •�y:Sr�r.'� <br />__.._ . / <br />� �o}`rc-� cpted..__.� t_"___'_191 R} L' �-`�'�i--______""' _ ' __ <br />• �4 - - � ��� SuperinlenCen <br />��;'� � : i � - � <br />��.__�_._ _ .. �. <br />