Laserfiche WebLink
.. • —'-l�r->j />7 <br />l— �/ 1 Y � J � " _ _. . . <br />•W. D. Form a ISOG 34�17 C. P. <br />CITY OF EVERETT==Water Department <br />Application for Water <br />All blanks must be filled in or crnssed out <br />�.;11' .�. ,. � .� <br />p.__"_-__-1�_._ <br />� �:,.�r�«. --- --- --- -- --?- <br />, <br />, � TO TH6 SUPF.RINTENDIiNT CI '` �Or�F�I RETT PARTMENT. <br />i hereby aPP�Y for lhe use �f w''�nse.s atx� fixtmes sta ed bdows and regula� <br />. . ur ur in �( <br />�nt ( P . rcasi <br />�„ n �, <br />rt . . <br />Natcr D� ia . kcn u Y <br />I u( 7'he 4 ., a� be ta P <br />, uun� <br />During Ihe ti.ne lhal any of the wa«r mams �, <br />any impruvemcnls aulhorized hc the Cit.� ��f liverc�t. in �r of any streM ��r allcY in <br />r tl a � �Rr s no( a'ueheir.iprovement�s t"���� �consum�errcwh�i c� suPpl� �may thus bercn i <br />� nf(, on c� liablc for anp damaKes (ur its tailmc so to dn. <br />ApplicnlionNa.__.__����—' "✓)�"%y�—� a� � <br />�' ___"_Add.'_'.." <br />_..._ <br />(J - <br />� 131nck..__'.____._._._Lnt_______..__. , • • <br />s�ht-�—ye — ^'-�-� -/ <br />a;�,._�_��Q-�-u�� �C�� <br />I ----.p��_.C.f._�__' _ U---.._�C%Q¢-5-,o-e.'f-�``----- --- r�umbe� <br />"fhe work to be executed b)'- . <br />; a ^on�if,e,_,':i.on iiarenf r,;:�s np li�,an� <br />Sta�e sim o( tap. -� . �7�, <br />i::'o:�ncc�ion .ztiioiit noticr, <br />�'i�_.__Tavmbc4�i�Q�?1�tterR'Jncecbor l�t, 19:13 if title to <br />--_-_w,i�rd�,�eia 1;:Le line ia �iot, '03; Doco�.�Ucr lst, 19:.3 <br />I � ;. nnr, a.' a L.I.D. :ron :.:m:ilteo <br />�— <br />,, _.___I3ath obtnitted by <br />i Qil�� 111 SUC)1 OVO:lo ���]1S <br />^�7rinal ';;p;ol' Di��+7^�c't� q <br />- 1� ru•rtht;r :. ,r� "� �;o pay �;ie ccat o_ <br />I �_. Plain faucet:ip�drt%"�� • y . <br />- . '.o ;nc p�:.�y mnY.i:li: e•;..,,. <br />�. y, �o..:;oc�ion <br />---Side u�alk a^idf'�r -�/ ,, 1 S. � p '.: ; o <br />_ .. _ _ _ i �/`c '� .� <br />___`-'--.'HoseUibuutside :. j <br />�� _ Hosc bib !or huilding Pu�P°�es � . <br />__'_'_.._ , <br />' _' ' _ Husc bib insidc �. <br />_"_ ___13ibforstableconlainin�_----- <br />_.-slail_._ .__� , <br />_ � __Numbrr n( pereons in famil3' � <br />. _ �__Number o( moms in building . � � <br />— ____. <br />___'_. _ '_____' <br />The p�emises are tn be used as a-. -- -- � � �/� <br />�x�¢.5�t'___._____.._-. <br />The owner �f the premises is _- -- -- --- <br />TheaHcnt is ..__'___'_..--.--___________ .-_ <br />.__--_.—_�T.—^____'_____ <br />This :+pplication. althouQh siFncd. shall nol bc bindinK up��n thc Cily, unti� ao <br />nre.�, uy Thc Superimende ��< <��e Nxter Uepartme � ` <br />.�[<,'l.�.(i�f_ _ _ _ _ _ _ .. _ ApPlicant <br />XSigned <br />..__.._ �[.Q/l!�_ .__ . <br />� <br />-__--------�---- <br />191 Y-- i ' su;<rirmn^_mt <br />ccpted_"."__"_ .i, <br />�„ ;�' c,'`�— ;�, <br />