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-_,�_- <br /> ,V.�. Foim< L-., ��, <br /> CITY OF EVERETT-WA7ER DEPARTMENT <br /> APPLICATION FOR a'�ATER <br /> Nl blanks mu=t bc filled in or crosred cut <br /> F.Vcrett,_....__._._. ...._....�b:2.s{...../�.._. .. . . .19:,. �; <br /> 7'O 'I'Iik: SLIi'P•.RI\1'ENDEN'f OP THE \VATER DEPARTMECJT: <br /> CITY OF EVF.RETT: <br /> I h�_reby apply for thc usc ot ^rate: in accordancc with thc rules and regu- <br /> I:�liuns o( the Waler Department, tor p.,:ruscs :md fixWres sta!ed Lcla�v. <br /> DurinF thc Limc ihat any ot the watcr mains rv�p bc taken up by rms�m <br /> nf any improvements authorized bv the C�h• of Evcrett, in or of ar.y sUcet or <br /> allcy in which they mcy]iave Uecn laid, the City�vi71 nol be tcquired tn turnish <br /> «�:rter during the progress u[ such improven:ente to any consumer �eliose sup- <br /> pt}• may thus be cut off, or be liable fnr any damages far its failure so lo do. <br /> �. -_ -�j. <br /> Application No..�..'.._...._ . , � <br /> r <br /> •� _ ,f���^•'% <br /> I3lock._......_............................Lot............._.�,.—.._.'........ Add... <br /> __....... ._.__. <br /> ` � _. .. .___. <br /> xa...._....._:�'�'.c....9.c........�......_.........�'�- scecce <br /> _... ................................................_..................................................................._................... .._. <br /> The work to Ue execcted by... ..._.......__......._._._...__......_........__........Plumber <br /> Statc sizc of lap. <br /> _.:�Y....Tap t.o bc inserted in thc main. ��,r.''�%�-� <br /> ...........__..lVater closet <br /> i/ y <br /> ��' - . � . , . ....(.....BaUt (�� �,l� <br /> . , 'pt : ( a��� <br /> ( � ��m, � ��, . . .. . .Uri�al . � <br /> � ' 't�;r� �" � ' . . ....... Pl,im taucet insidc /�/h �,� . <br /> i . �yi . M �. . ... .... Sidc walk washer � <br /> •. y�,f', ' . : �Y��y �� <br /> - ' 'fy .'� x , , , . ....... I;osc Uib outside \� ��%r.,: <br /> � f , <br /> ' , �1 r � � ' ,� . . ' . . ....__....Iiose b�b tor Uwldinp Purposes ' ' '. . �cc>' ., • % <br /> . .�r � d�Ya .� � , .... .... IIcsc bib insidc ., _ <br /> ._ s� �� � .....BiU Cor siaUlc containing .. ._...__..sl:Jl ��.� : <br /> �i F� r �'�.' � ,. ._._ _.. <br /> -.�� 4�' ��� .', '.,' �� _�� � __._Number ot persons in t un�ly <br /> -, � <br /> �• �:..ri;.ir':r' - "� ` � .�...__.Numbcr of rnoms in Uuildin;; <br /> Thc premises arc to Uc used as n_._...._. . _. . . <br /> Thc nwner of the premises is_..._ ._. . _... .__......_ .......... . ... <br /> _ _ <br /> T'ue agent is.............. ....._.___... __..___...___......_............_........... <br /> This ap�lication, althou�:h signcd, shal] not bc Uinding upon the City, until <br /> n[ceptcd by lhc Superintrrdent of the Wakr Depaytment. �� �• <br /> i / / . > � ' <br /> .__ �c.l Ct�_� <c_t ( t:. <br /> Si:�ned �.!`T"' ` . ° � s _'-0r:�:.._.Lpplicant `�^►.• � <br /> A. o:cd._ . .. . . � IP.. 13v ...•� bY7 <br /> / <br /> . ... . .. .. ........... ___._ � t <br /> ._.S:�perir.lcndent. <br />