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�ti�' � v-- -� -- � , .... c:. � ,�-r��' 2-2G -1 4-- /Il. <br />':. U. Form � I C-00 d-61 ] G. Y. � . <br />CITV OF EVERETT==��atcr Depart�neni <br />Applicatio�ra for Water <br />:111 blankc musl be � led in nr crosscd ou� <br />F.veret[�. .__'�/ ��5�__•'�" .--__--_.19j:Z�.. <br />l'HL SUPCRINTiiNDIiNT OF'fHti NA'fI:R ➢I:PAR7'�tli\1', <br />CI'1'1' OR li:'f:RIiTT: <br />I hereby apply fnr the nse nf ���.�ter in accordance with the rules and reAula� <br />( l'he 1Vater D:parUn �nt. fnr purpnses :md fistures slated beimv. <br />Uurinq Ihc limc that any nf thc m'a�cr mains mny br �akcn up My rcason of <br />���.nroveme�n. authorized bo O�.c City o( F.��crel:. in ur n( any sircM ��r alley in <br />�h thcv nrn have hecn IaiJ. ihr City w�iil not be required tn (urnish �rater durinF <br />�xoeress of such imprnvements �n any cunsum��r a�hose supply ma7' Ihus be cut <br />�tt �,i�r linble fnr any dantfagesy�' its failure sa Io dn. <br />Ap;,'.icntinn No.__ �v. � �"'-" <br />Hlo r, -"' ._."' - -'_Lut.__ "" ' -- - _'- Add '_ � <br />:,,. ���s� ��•.� .� s`��� <br />---- ---. --- — — -- --- <br />.. <br />..haworklnbeexecitleJU}'._.__.-___________ ________________Plumhcr ,.�.'��. <br />_I�� �i�e uf [�p. �' . <br />, " �� �o �, <br />....'I'ap to be inserteJ in the main. <br />._N'ater closet - <br />_ / <br />-. . _.R:rth ,q ����� <br />_ _ . Urinal � ��I � <br />Plain fnucct insidr � ` � <br />n�2��, I <br />. . _ .. _. . Side �valk washcr /y v /[ �). (�' / �- ' <br />__. __Ilnsc bib uutside � �� � <br />_____ . _Ilasc bib (or builJing purnn.r. <br />. _. . _ _ _. _Huse Ui6 inside <br />._'__.___t3ibfnrstablecont:�ininl' . . . =t:ii1 . . . <br />_' _. "'_Numb��r u( persons in (amily <br />-_____'___Numbcr nf rnnm.. in buildin�; <br />"1'hepremisesamtobcusrJasa_-__- -__.___ ..._._______________ ______ <br />7'henwnerofthepremisesis__________.._.__ _ ._ .____. <br />'PheaKenlis '__.___._ .._ __.'________.'___' _____' <br />_..___'___. .....__ <br />l�his ap; iic:�tion. allhouFh siKncd, shall nut bc binding upnn tl�c Ciry•. until :io <br />,rptc � by Thc Superimcndent he NntcrJ�art��. <br />� Siqncd �.�___�_�`__��"��/luT'�+' �_Applicant <br />, _. ^ . . ._.. .___ <br />. <br />� :rceplcd _. ___"__'_"'_1!11 RS'____'_G\. I .__ _ .__ <br />� -� /' _ �.���?�� > �,. ��.E��, <br />�� � <br />