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'Gt,�L..•� �, � -��S c�.. _'-'i L-,.2L- 30 <br />\S. D. 1'urm i— IG9U—E,P.0 �.—�-26-2d <br />C.ity of �verett�Watei� Depai�tinent <br />APPLICATION FOR WATER <br />All blauks must be filled in or crossed out <br />Cverett ................_............._... ��� b......_.........1°'!'..Q. <br />/ <br />7'0 17I13 SUPERINTLNU�NT 01� THE WATGR DEPAI.TDILN'P: <br />C1TY OF P•.VEItETT: <br />I hereby apply Lor the use of t�•aLer in accordance u•ith tl�e rules nnd regu- <br />Intions of thc ��'nter Depnrtment, for purposes .md tistm�es stated brlaw. <br />Dm�ing the time tFmt nny uC the �cater mnins mny be lalcen up 6y renson <br />of nny improvemm�ts nutl�orized Ly [Le Citp of F.�'crett, in or of nny slreet or <br />�illry in �chirh thcy may hnrc becn lnid, thc City will not Lc rc,nircd l.o furni;L <br />u•nter daring ihe progress of such improvements to nny consumer �chose supplV <br />nriy thus 6c cut oft, or Lpe liaLle fa� nny diumige= for its fnilure so to do. <br />Applicntion No.._....._.L..�....J.�...�..........- %`fo� <br />r <br />Blocic ...............�................y......�.. Lotp..�........._.�..._................_. . Add.. ��_t./•.-� �. t', �._ <br />. ._....`�...__.._.__ . <br />No__. .3.$ � Z._... �.% t<Cil�f--�-!-�rGC.-Q.i�reet <br />0 <br />_. _......__ _ __............__...._.__..__._.._ ...........�..._._._.n....../..._...... ........._.......__............... <br />The �cark to be executed UY....._.__..._. _.�`-�-..._._...__.._......._..Plum6cr <br />Stnte sizc of tnp. D <br />....�...::...Tnp to Uc inser[ed in thc main. c- �� � <br />// ._ - r ., .— <br />__.�...._...C.'nter daset �o � <br />..�............Bnth <br />�� . <br />. .. ........_Ur�nal <br />..�.`.-......Plnin faucet insidc � . <br />........Sidc n•nik wnslier . �. . <br />L - <br />................Sln=c bib oulside <br />....._.........Iluse Uib for building purposes � <br />.._.`..........]Insc biU inside . <br />�--. <br />................Bib for staUlc contnining....................stnll.................... <br />.._. ._.Number ot persons in fnmily <br />.... S. .....Numbcr of rooms in Uuildi�ig . <br />The premises nrn to Uc used us a__ ��^q........ <br />�-tycr..u'.�'-'( ......_. :y` <br />Thc o�vner of the premiees �s ....C�j'�,s.vr.... ... _.� i <br />Thcngent is ............................._.................._........................................_..._.............._._. <br />This npplicntian, nithough �igned, shall not bc Uinding upon Lhe Cily, until <br />�ted by the SuPcrinic� it of thc \Yj��'�� e{yirtment. <br />Signed...._.......... . _ .. ..... ... ..... _..../-..�i=..C/............. _......._.......Applicnnt <br />�:ed._...�..'..,.�.�.�./..`......... . .. Dy... ....,�f�,f-.l. ......-- <br />� Su�r�dent <br />m <br />