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Git�Cl� �- ''. :'� -� .�✓ P <br />NTD 2 - �/.. '�. ._. ., �� <br />� - -1� � _ <br />W. IJ. Form 1 I500 d-i- V C, p, <br />CITY OF EVERETT==Water Department <br />Application for Water <br />All Ulanks mus[ bc filled in or cr.n�c e/d nut <br />Everelt..__'____.___._'____'_/ 9. __'__.___.19�_.'L'_ <br />TO 1'HE SUPI3RIN7'END6N7' OF TIIE NA'1'IiR DEPARTRfENT, <br />C17'Y OF E`/GRETT: <br />1 hereby apply (ur the use of water in accordance ailh the rules and regula� <br />tion, of The Natcr U:partment, (nr pnrposc� ;md fi�wres sta[ed bclo�v. <br />During [he [imc Ihat any of the water niains ma�� br takcn up by reason o( <br />nny improvenents authnri2ed by ihe l'itp o( F,vr.ret[, in nr o( nny slrce[ nr ailey in <br />which thel' ��»Y havr Aeen laid, thc City will not 6e required to furnfsh watcr tiuring <br />tlie progress o( such improvemems tn am consumer ���hnse suppl}� may ihus be nu <br />a(f. or bc IiaLlc tor any �d7amages q!or its L�ilure su In du. <br />APPI icntior Nu.' _' J_'� _ [ _7 ' _ <br />Blnck .�_�.5.-- --Lot.-.�' Add---_ <br />. �---------- <br />�---------- <br />--.��..___J9,2_7_._ _�. <br />-� ------ __ .str��c <br />�--�---' � ------'--- ----------------------------------- <br />Thc�eodctobcesecuted6Y.__.__"__'___' ___.__.___..__ Plumbcr-_ <br />Jt � Size of tap. � � � � <br />/ i <br />Z.-'Pap to bc inserted in thc main. � — I S��°, <br />--_. _ � _. .1Vatcr closct <br />___. � _._.Ral'n <br />---...__ .Urinnl <br />---'__..__Plain faucetinside <br />- _______.Side walk n�ashcr <br />--_______Hosc bibautside <br />--"_' ___. Hnsc bib (or bu ilding purpuses <br />- _ _ _ _ _ _ . Hasc bib insidc /", ...., <br />-"'_'_'__13ibforstablecontnininq______ �� <br />_..slall._.__�_._. <br />-'- _. Nmnber nf persons in (amil�• <br />__ �__'Numbcr of moms in building . <br />The premi�es nre tu be u;ed as a._. __ .._. <br />_.__"___"."_"__'__'_._' _'_"' <br />The oaner nf Ihe nremises is ____ _. _ <br />..______. _ . _. _.______'.______ ____ <br />Theagentis '__'___,___ <br />.._.__"_.__.__'_._ _____".'____.'_'____' <br />This applica�iou, althougli si�;ned�. slinll nnt be bindin�! upon lhe City, tmtil ao- <br />cepted by Thc Superintendent u( ti�i �i'nler Deparlment. <br />5'r�ed..__��_'_.�i[��.(it-- ..______Applicant <br />Accepted.._� �___1�Z- By�J- / <br />_ i � <br />' � ._.��-�..��.surerlmen�_m � <br />