Laserfiche WebLink
/r �' �- <br /> w.o. Fo�m: <br /> CIT)' OF EVEItE7T-WATER DEPARTMENT <br /> A�PLICATION FOR WATER <br /> :111 Ulanks must hc tilled in or crossed ou: <br /> Evcrett,.__.__._.__.._.�^.:n�...,-.%. C..........__..___._..19�"..� <br /> 7'O THE SliPERIA`TESDliN'C OF THE NATER DEPART\SENT: <br /> CITY OF' EVERETT: <br /> I hereby apU�Y �a�' ���e i�se ot water in accordanee with the rtiles and regw <br /> I�tions o[ thc \Vater Department, for purpoecs and ti;:tures slalcd bclow. <br /> During thc limc that any of lhc �ralcr main: may Uc t�ken up hy rmson <br /> o: any improvements authorized Uy thc Cil� of 3:vcrctt, in or of any slroct or <br /> alley in �ehich thcl'may havc bcen]aid, [hc City will not Fc required to fornish <br /> water dunng the progress of such im��rovements to any consumer whose sup- <br /> pIy may thus bc cut otf, or Ue liable for any damages fur its tailure so to do. <br /> - � <br /> Applic�lio» No.._.��..'�.........._....._. <br /> Block......__.... . . ......... .Lot...__._.... .._ ._ .._..._ Add..._.... _ ._........._..... ....._. ' <br /> p > < �' . <br /> No.........l..l�.:�.'. ./..�.....-.....� . ::... r-c�.e. ......Blrer.t <br /> . ........................................... <br /> ._.. ....................................._............_......................................................................................... <br /> 'Pls work lo be execnted by_. .........__.._....__.__ ........_...._..._._....._._..Plumbcr <br /> Sta�lc/sizc of tap. �� <br /> .. /.�..Tap lo bc inserted in the maia .�•-�"''�� <br /> ���� ' <br /> _...._........�5'atcr :toscl � • � <br /> .._c'.".......Ra!h �� �l , <br /> l�,l �j� � �9 <br /> ._.___.......iirinal ; % .f"-'--.'i i,- � � �yy I <br /> Plain faucet insidc �'� ,� '� � � � <br /> _._____.. C n i� .. .��� � � �i <br /> _ _._._....Fidc walk washer .. : {V <br /> . ..__......Idosc bib oulside '.:/f_✓ �� N <br /> . _.... ......IIose bib for bnilding purposes +�a ) + <br /> � <br /> ......._.._...Ifosc bib insida <br /> .. . .___....IIib for stablc containing...._......._.._sta1L._......_.....,., , : <br /> . __ .......Numtcr of persons in family <br /> . �_....Numbcr of rooms in Uuilding <br /> Thc Premises are to be uscd as a_....._..............._._. ...__...._.._ _....._..._............._ �. <br /> 1'hc rwncr ot lhc premiscs is..__._..._...... ........_.._._ .__........_.. <br /> ............._ .. .._ ___. <br /> TScagent is...__..._......__..._...... . ...__.__...__.._._._................_.. ............ . <br /> . _ ._._..... <br /> 7'Li., applicatior., al!hou�sh siFncd. =hall not bc binding �gon the.City, until <br /> :ircop4d by thc SuFcrmtcr.icnt o[ t�c lVaterD partme7�l. l <br /> . / /�/ <br /> Si Gned�r..i.=.,!'l.�._�.�.....�.L�_.,F�.:t�4,(...APPlicant <br /> :\eerp:�d.... . . . . _ . . .. 1!!. . _. flS .._.... . .. _ . .... <br /> SUP��'inicndcnL.. <br />