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i <br /> I <br /> I <br /> ,' <br /> I <br /> .� <br /> ! <br /> I <br /> . . FNT77. �-^- r•"r ry� . ' <br /> � :� `. <br /> \\'. D. Fonn a 1500 d-1-17 C.P. . <br /> GITY OF EVERETT==Water Department <br /> Application for Water <br /> All Ulanks must bc fillcd in nr�s. �d �iut <br /> i <br /> li�•ei�tt. . ' - __ __'_"___ ________191 -9- <br /> 'PO 'I'I1E SUPIiRINTENUIiN'1'OF 9'HF.WA 'ER UEPART\IF.K'P, <br /> CI"1'1'OF GVERET'C: <br /> I hereby,PpIY f��r the use nf u�ater in accordance wilh the rules�nd reRuL•a <br /> ;i.ins uf The 1Vatcr Departnr_m. (or purposes and fixmres s[ated beloa•. <br /> During[he timc lhat any u( lhe water mains m:q�be inken up by rcasun o( <br /> :mc imnrovcments authorized bp tUc Cilc of F.verctt,in ur nf anY sircet nr alle}' in <br /> which they may hnve been laid, thc Ciq• will not bc mquircd tn furnish water during <br /> the prngress ot such improvemenls tn any eonsumer whnse supply map �hus be cul <br /> n(i, nr 6e 1ia61c for�ny dan���cs for its f�ilure so lu do. <br /> Applirntiun No..v��f�.7"'-" <br /> �_ <br /> Rluck .�_'�'�....._Lot"'_" _J1�__'�_".Add__""'_.'-_-'-""_' <br /> \o.�✓�.�-�_ _. . __'.__'. : 'i`�.._'_'..Strect <br /> ----'---...-_-"'- � ---��=—_---�------�------""--- � <br /> 'Phe �rork ro 6e executed by.-_._.-_._____ .____.-__..-___"____' Plumber <br /> State ixo nt tnp. <br /> r <br />: ___��__-Tnp In be inserted in the main. / � <br /> ry L <br /> "'_l- N'mercloset '.': O f. <br /> ""�"_ l3ath •.. <br /> . ___.'___ .Urinal ..•Jt'LL�\ . <br /> ___Pl:iin fnucet insidc . . �s.- V <br /> . ---- � ��� <br /> � ._._'__'__Side�rnik washcr �.:'7 � I�� , . <br /> """""_Hnscbibnutsidc � �I//��I (/, � <br /> ___IloscLibtorbuildintiP��rpnses � .�,�' 'I�� �`;. . <br /> """' 1�"� r. <br /> ___"_.Hosc bib inside �, �'+� Npr�, � i{;7¢,� ' <br /> , �; <br /> 13ibforstablecontaining____--slall_'.^:,_� `-- ; '. <br /> _""""' `-_ �. <br />� __ Numbcr ut persons in family � ,r�': <br /> r �a:. C . <br /> -- _v_Numbcr o(runms in building :��`_J�:�:,,�. <br /> 'Phe Premises are ta bc useJ as a___'-.-."____'_""".""""""_" '__"' <br /> "1'hcnancrnfthcpremisesis "___'_____'__._._. _.___._______'__"_.___'. <br /> 'Phe aHentis .--_ ..---�-�- -�-----'-----�- - .. _�--------'--. ... ---��---- <br /> 7'his applicalion. although signeJ, shall nut be binding upnn the Ciq', until :ic� <br /> i crpted by The Superintcndcnt nf the �Vpter Ue�nment. _ <br /> � /,�// �. <br />' 1 „G <br />� giRneJ ._ L'l- i!v�-� " -�/-�... __. _ _,_...- _Ap icant <br /> /' '.�/',�" <br /> II Atcr ted "'��.._..l`u� .,�-�7C-\__ _ _""'__' _ <br /> f / V -�'----'--gnr•nmrnr.em <br /> i <br />