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✓� :�`'� �I , .. " " <br />k'. D. f'ouvl 1 i00 YI-1 ] C. P. ..• <br />CITY OF EVCRETT==Water Department <br />Applica�ic�n for Water <br />r'. <br />All bl:mks must bc filled in or cross/ed/nut <br />Gvemlt_ __ __________ _""/ Z � ..__.191�__-:. <br />7'U TNF SUFI:RINTBNDI3N'1' OP T211? \1'.\TL•;< DEPARTTIEN7', <br />C17'1' OP G`JfI:ITT: <br />1 hereby apply for ihe rse u( ��•ater iu accordnnce w'ilh the rules and regula� <br />tiunc n( Thc Na1er Dep;:rtmrnt, tnr purpose�: anci fismres statcd bclnw. <br />Um�ing the time that :u�.c nf !he ��vater mains may be taken up by reason o( <br />any impruvements cuthorizrd br tha Ciiy of Geen•n, in or of anp strcet nr allcy in <br />���hich [hey n:-�iy have been I�id, the City o�ill not be i;quired tu R�rni�h water during <br />[he prngress o( sneh improvem�nl, In anY rnnsumer �chosC supplc may Ihuc be cut <br />ot(, ur bc liablc for any damages fur ite (ailure sn In do. <br />� I Lt Lj <br />n�or��c��,o v�.-- — 0 ---------- <br />�ii����: _ 5.S-� --- -�.o�---�-�----- --- - naa..- — — -- <br />. h � <br />\o. _ _ %_ _ S_ -� .-7 . . _ �.1' kr2�'�� _ _ .. Streel <br />_..-_'____'_ . __.._.___._.__/ ._j.__.__'_'__________"'___""._____ <br />"fhc �eork tn 6c execWcd by._____-L-�.����-Ul___'__"__ Plumber <br />State sizc n( tap. <br />__�/2/.._Tap to uc inserteJ in the main. <br />_.�..�__.__Nmercluset ' � � �;J - <br />___.(..___ftath �., _�L-.. <br />j:./ �YE:fj4� .. <br />. . .Urinal '.1✓ -���t . <br />.__.___Plain faucetinsidc �J� ;, �� � <br />\�y;` a `� <br />_. __"Side a•alk washer i� Ir^I ��'`Q�O� � JJ <br />__.""'._HuscbiboWsiJc ii— .•� <br />t,�1 t�Q1 r�. I <br />__________IlosebibfnrbuildinFPurpn.ey`��'� t\ ' �, � �-..�1 <br />:r � � ' ^� � <br />__Hose bib inside `'� <br />�i_ . �� ; . ; <br />. .:: <br />_.__'.'__13ibforslablecoutainin�.____'__._slz��«-��.'� �� <br />� '.VL�':._.-. <br />__.._---__.Numbrrof persuns in famil}• •..;�� <br />._'�_____Numbcr nf ranms in Luilding <br />7'he prcmises are tu 6c used as a_.._.. ._________„'/' ""____._. <br />'I'heownero(Ihepreutisesis ___"______'__.. <br />Thcagcn[ is . __..-..__ _ __. .__. __' . -� <br />'1'his apPlication. althuuAl ig •d. sha un b ir <br />i <br />rrpled by Thc Superimendc hr id Depar <br />Sigfied __". �__ � � ___ _ I� <br />, '� � , <br />Acccptca 'ri>•- �/�, /]� <br />�� �.. �� �/ / <br />� '___""._."___^""' <br />_.\"_'I"" '_'/J_" <br />__'___ .,�.envmn\ <br />