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N�. _�. r��„ �:sce 3.i-n c. r. -' . <br />CITY OF EVERETT==Water Department <br />Application for Water <br />:\II blanks must bc filled in or crn�sc�it <br />r,���ic. -__ _— —'/—=/ ---- ,�.Y__ <br />ro •ri�� su��r:ei���e:ancn•r or � F3r•. wn•��eie urt���rrnn_N��. <br />GI"1'Y OF Ii7F.RI:PT: <br />I hereLy apply for ihe nse n( ieate� in accmdance with lhe iaies and regula� <br />tiun: n( The N�ter Uzpartment, fur purpuses :�nd tistures stated bclo«•. <br />Uuring the time �hat :my nt the �cme.r m,�.ins mm• br taAen up uy reaum o( <br />:mv imPruvemen(s authurized bc the Ci�v o( li�rrei�. in nr of an�� st�ee� nr :dlry in <br />�vhirh lhep ma1' have 6een Inid. thc litr icill not be rt9uired tu lurnisl� w•ater dm�ing <br />ehi• proRm=s o( such improvemrntr tn :my consumrr r: L��.e supply may t!ms br i�ut <br />�+It. or bc liablc fnr an/y damngcs for ils (ailure so In d�. <br />:\PpIiCnlionNn .C�_��/-__...__. <br />� `.,, i <br />BI��cA _'_"_'�'t' "... .Lot...."� _(�'_'Add .__'_._ ............. <br />-� � ,( . � _ <br />\u...�-�.:�.3'�C/-'n"cic_" ��.-_"_.Slrecl <br />.._._ . .. .... ... ........r_.. ...___�_ �. ____"_"_""__"_ <br />'fhe �rurA �n hr eaecuteel b}•- ""_'_ `<tili?�^.t�^ea�.'_'___ Plumber <br />Slale tzr nf tr�p. �� <br />� � <br />..7_..Tap to be inrenrd in the main. <br />.".. �-._R'atc�clo�rt � / •- / p �., <br />. .'� ---.13a1h /.L �—_ <br />--. T_- .Urinal <br />_ � ..Plain fsucrt insidc / <br />h __Side �cnik w�ashcr � <br />i���� <br />_ _/-.._Hose bib uutside " `) <br />. _?__..liosc 6ib for building purpnsrs <br />. .� ._..11nsc bib inxidc <br />-""_h_'.UibfnrstablccontaininR_'-__ . :lnil. _.. . <br />..__ %`.__'Numbcrof pirsor.s in L•unily. <br />__ �.___Number af rumm� in 6uildinF <br />'Phe premi.c. are tu be used as a _ . _. � ,):�� c�� L _ . . _ . . <br />/ _ _ <br />The uwner o! the prrmises �v �L.L�(�*� .���-.r•_..5<•-.__ <br />_.__ _ <br />1�heagenti5 __ . ..... . . ....... ...... .. . .. <br />--. � <br />fhis applicalion. althouFh siKnrd. shall nut br iindiug up��n lhc CitY, Unlil :it. <br />� eptn' bc The SuPerini�.ndent o( Ihr N'n�rr Depai�ni�nt. <br />��7��� � ♦ <br />Siµned . _ _ _ . .' _ _ . _ . -C.�.�� �}':.('jrtU'li�,l!W' . _ _ Appl icant <br />- �.l � � <br />a��rP��a., �./-- �� �s� k oi,. -- ---- .. <br />% �' � J _, .���,�.,.�, <br />: �. �'' == r'� <br />