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. . ✓ :!�'�i. �. .� ' - ' <br /> � � . A <br /> V.'. L. Fo�m� ISOJ :�-bI]C.7. <br /> CITY 0� EVERETT==Water Department <br /> Application for Water <br /> AI! blanks nmst h ltgd in or rrnssed uut <br /> __' �� <br /> F.ccrett..""' � -.__"'"lfli�.�� <br /> 'PO 'I'I IE SUPIiIiIN'PF.�'DHI�T y7F' 1Ii NA7'IiR DGi AKT\1GNT. <br /> �1,� 'UP IiVGRL•'7'T: <br /> _ I hereby:+pPly (ur thc use ni waler in nnorclance with !hc rules nnd reg�dn- <br /> ti m;uf Thc Water Uep�rtm�nt, fnr pwpuse� and lixuves stated belne�. <br /> U�nin�the lime Ih�u any n( �he �cater mains may he taken up 6y reasnn u( <br /> :my imurnvemenls aulhnrized Lc lhe Citc or G�crrtl.in nr n( :my slreM �m allcy in <br /> •,rhich lhrv mn5'havc bcen laid. thc City�vill n-�l bc:cquircd io lurnish n�alcr durin�; <br /> the prnRr�•ss nf sUch iinPrnvemenls l�� anp cuneumer �chosr cuPplc may Ihus be cut <br /> n(L��r be liablc far:my damaues fur iis(aihvc�u to do. <br /> �1Pplicnt;on Nu.__ ._��/ ."' <br /> 9 <br /> - - <br /> ui,�.•k �. �,i— � -- ,�aa __ . . — - <br /> — - 7 - <br /> ���. — � —�.��-��`-?-!t-c�ci ---. sire�i <br /> ___._ _ — - — ---- - - — ----- ------ <br /> 'I'he �ru�klubeesecutedby..-_.--_._____' ._-_._..__..___.. ___ Phunher <br /> titalc:izCnf�ap. —� o <br /> / .( o <br /> '_.�_Tn�l l0�le i115CrIC�1 ill llll't»aill. . _J ✓ <br /> ___..�..___���AICf C�atiCi <br /> ---.�.--.Bath <br /> __. ..-_ .Urinal <br /> .__'_'_Plnin f:wcet insidc <br /> _'_'_'Sidr �calk teashcr � <br /> .. _.'__'_'Hu�e 6ib outside <br /> ' ' _'___..._.Ilo�e 6i6(orbuil:lin{� Durpnscs . <br /> _"_'_ <br /> ..Ilusc bib insidc �� . � <br /> � � ._.f3ibforslablccnntaining_'__... .._.:�IaIL__ ..__ <br /> "' '"� .Numbcr n(Persons in famip. <br /> . __�__Numhar n(room>in building <br /> ThePrrniscsaretobcusedasa_.__ . "__'-- "'_. -' . _ '_--.- ....... <br /> "I'BcawncrutdicPrvmis�sis _.__- . _ ...__. .---__ _._____ _--- <br />� l'heaRentis ___._ ._..... ....'_"______ .___.____-____.'_..____.__' <br /> This applie�tion.altlmugh ni�rvd,shall nut be binding upun thc Ciq•, until ac <br /> neJ ny T ,a SuneriNendent uf the N�der Ucparintent. <br /> Signed -__�l�`��'�S?�vL/�'i-�� _ ' --_ _':\pPlicant . <br /> AccePled.G..r,. O-_-]`1h Ii�r.��� _ ________ _____ I. <br /> � — ` : iV/. _�..�i ���,:«� <br />