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.. . 7 ,�l �l — '� . � , 1 iJ•' <br />. ' f% <br />' W. D. Form 1 I500 J-I-17 Q P. � ' . <br />CITY OF EVERETT�=Water Department <br />Application for Wat�r 'r <br />All blanks must be fillyd iu or crasscd uut <br />—_ 6 � L. <br />Everell.. _."' _ _'__"_'_ . .-.5""_191 y-'_ <br />"fu 1'NN Sl1P1iNIN'fF.NUIiN'1' OP TfiE WA1'ER UBP.qMfT11iN9', <br />C19'Y OF' EVGRE7'T: <br />' 1 hereby apply tor �he use n( w�ter in :�ccordance with the rWes and reKuia� <br />ti��.is uf 7'he Water Uepartmrnt. (cr purpunrs and fisturrs si-.ted hclow. <br />DurinR tlu limc Ihal aup uf Ihc wa[cr m:�ins may bc taken up by rcason uf <br />:m> imprnvements nuUiorized by the City at Evercit, in or n( any strcet or alicp in <br />which they may havc heen IaiA, Ihe City w�ill nut be required tu furnish watcr during <br />the prugress nf such impmvemenls tn any consumer n•hnse supplr may Ihus be cut <br />nif. or be liablc (nr any dra�m;iges for its failure so ln do. <br />APplirnl ion No..' _, l. �' b' /' _' __p <br />Rluck � "1 . _ ---Lnt-----'-�o-- <br />...... _.,.�_ _._Add.."_ <br />�1 p -_-__ . ___..-_._- <br />Nu. _ _ _ . .. _ =! .�_ �_ _ D-"'r-.%..t.i. G. _r.'.C: L . St reet <br />.___....'_. . _'_"__"._ <br />- _ `_ _____'___ ____"__' _ __ <br />r ___' <br />_._ . <br />"I'he w•ork In Ix executed Ly _' �' —f'�_�e� Q.t,.--.ti.�'. _'_ plumbcr <br />,tatc sixe or tap. � . <br />� `' <br />.Tap to be inserted in Ihe main. <br />'� __'_ _ W�ter elocel �.. <br />i > . <br />�--- �i,ch n ; " j� -' f <br />_..__ .Urinal <br />.__"___._Plnin (aucet insidc <br />._. ____Sidc �ealk �va�hcr <br />_ . _.._Hnsc biL omside <br />. ._. ..flose bib for iwildinK p��r{w�ses <br />3' <br />��i ( <br />i <br />. ___Hnse bib insidc Q,��% <br />0�" �'__""'_liib (nrstablc cuntaining.'_"'_"'_ _stall- \� <br />. _ . _ . _'_"Numbcr of persnns in fantilY ��1 <br />.,� _"_'Numbcr af mnms in building. - , <br />'1'he premises are tu be u,r.d as a___r� S-_'-_..�.SJ.�_,(,(.S <br />7'he m��ner of �hc premises is ' _' _ " _ _ _" _' _ . _ _ . ' _' _ _' _' _ <br />. _._____. __. <br />1'he agenl is_ _"'"__.._.'__"_'_"" <br />'__-__'_ """' "_'_"_'_ <br />This application. although signc<I. shall not bc bindiny u�m thc Ci1y. until aa <br />u.•�rd by The Superimendent af Ihe 1Vn4r epnU �ent. - <br />Si�;nrd _""� "" ���C/n <br />.. ""__" ' '" _ ""_nPPlicant <br />_.__"__ <br />Arccpted � y. ..________1:+1� ItLl��r� �� / <br />/ ;�' / ___ f <br />. _�...�,,�.��:«� <br />