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�,��( G -i 7 - 7�� r.�J � '���� 5� �'�� �''. � <br /> W.D. Fern 4 ISGO ]-1-1]C.P. <br /> CITY OF EVERETT�=Water Department <br /> Application for Water <br /> All hlanks must be filled in or crocsed nut ` � <br /> 3 / �J//_.__ <br /> F.verc�t. -' __'_'""___'.__'_'___lyi ./ <br /> TO 7'HE SUPF.RINTENUEN7'OF 7'HIi NA1'Ek DF.PANTMGNT, <br /> C11'Y�H�tiYBRETT: <br /> I herehy�pP�y fnr the use of��ater in :�ceorAance with the rules and rrgula- <br /> tinns u('Phe W;aer Departman[,fur purpnses and fixWms statcd 6eloe'. <br /> UurinK the timc that anY��f tlic watrr mains may bc takcn up by rcason uf <br /> nnq iinuruvements authorized 6y the Cin•a(Grerett,in or nf any strect or alle)' in <br /> which Chey maY have been laid,thc Cin'will not be requird lo lurnish waMr durinp <br /> �hc protiress nt such improvcmrnts to any cnnsumcr x�hnsc snpplp m�y Ihus bc cut <br /> nff,or bc liablc(or any danriK�'y p���r�jils' failure so tu do. <br /> Applirntinn Na_��. /--/----- <br /> Hlock , '�� __ .3 y. � <br /> .____-.____' __ / � � <br /> _Lnt _`'-._'_'.______.1dd-_______.____-__. <br /> ,�'o..��_�_�-- GGP�4!!v___.._.__..Strect <br /> __"""_"'..__"' "__""__ __"_____"_'._'__"_"""____"'_'_ <br /> '1'he work to be exccuted by --_.._._'---. --------'------- Plum6er <br /> Slale si,s.e/of lap. <br /> �__��Ly�_Tap to be inserted in ihe main. j '— , . . . <br /> � _Water eloset '��`���%^Y���EI ',\ . <br /> _ l i <br /> . �__.I3nth .'„fl� �'�\� ` �7� •,�.. <br /> � (�����,1 <br /> ,. �: <br /> - .__. .Urinal �4 ) �f� � 1 . , <br /> � <br /> ____'__..Plninfaucctinsidc .�.{ '�. <br /> ' C", <br /> .. ._..___Sidc�calk easher ��. � , •. (' : <br /> ._11ose bi6 outsidc •, ; _.- s;-' ' <br /> _____. - 6t...)+`. <br /> "Hosc bib tm'buildinF Pu�pnscs ,,` �� �': <br /> _'____ �'.. ' \i _.- `' <br /> � ��. .,�.t�'(� ' <br /> _________.Hosebibinsidc a'�.-.,� .l � <br /> '�..::�–r.��.•.' <br /> _ _'__.__Bibforstaldecontaining_____.._._.stall____. ___. <br /> ___'p__""Numbcr af Pcrvnns in famil>. <br /> . _.O___-Numbcr nf rucros in building <br /> i <br /> The premises are to be usrd as a_. ._ - - - �- ---� <br /> __ <br /> "' "' <br /> � 'Ch�• ownerofthePmmisesis _�"_�.�._''_. ._-.__. ___.. .___._.__. <br /> TheaRrn[ is ."'_"___._ . ___'__" '__"._"__'_' ._'__'_'_ <br /> This applicalicn.although signed,�hall not Lc binding upon thc CitY. ❑ntil nc / <br /> ceptcd by The Superintcndcnt o�f the Nnter Ueparimcut. <br /> Sitincd -_.__(/�_(�(�(L�(L�(�•�� ApPLcant <br /> } ��rp � /r --� <br /> AceepteJ.�-�`�9_�'_ '_�� B���O��1. ____'-'�n.�."""""' - . <br /> .�im��dm� <br />