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fc_1"`.��V`.1..�--�'��' •' �..� j', '� r. .�_i.._� i. , , "i %./J�}•' <br />�r. u. Porm �- isao--tiP.cm—c.xs-z� <br />Citv of Everett�Water Depai�tment <br />_CATION FOR WATER <br />All Ul:nilcs must Lc filled in or crossed out <br />� Evcrett........__......L(<.G.<,. �' 7 <br />. ....................................1p2...7 <br />1'O THli SUPF.121vT1A`DEv'I. OI�' TTIF, R'ATF.R�PAI;TIItiNT: <br />CITY OP IVliRPTS`: <br />I hcrcbY 1PP�1' for thc use ut �r:�t�r in aeent•d:mce �cith thc rule.s and regu. <br />Intmna of the ��'�ter Department, for pm�pu.es nnJ fis!mrs siated bclon•, <br />Uuring thc time Uint nny of the watcr mnins mny bc lnken up by rensan <br />o[ nnY ��nPravements authnrized Lp Um Citp of Erere[t, in nr nf miy strcet or <br />nllcy in whieh thcy mny hnce becn Inid, the Cily �eill not Lc required to furnish <br />�vaLer during the progress uC such imprm�ements to �my� consumer whose supply <br />m:q' thux bu cut oft, or bc IinLlc (or an{� c7mnngrs for ils fnihu�c eu �o do. <br />nn�u�ntton :.�o......�1..2�. .. . 7/�j3• <br />[31nck Cr �� �� <br />. �S 1 ....... Lat........ ... AJd... . __ . .._. <br />� � . ... . . _. <br />No .. . . ,.Ci �(/�`.. ...Street <br />� ....... <br />._.__... __._......_._.___ ............ ......_._.. ..._..._... <br />__ .. ___...__..__._.... <br />The �cork la be execuled by._ ... �„�/-�ti��:... <br />_. __..._..Plumber <br />Stn�t�e size of tn�i. <br />.._'/..z:.Tnp to bc inseY.cd in thc mnin. /S� <br />..._(.........{Vnlcr closet <br />.... �.........itntli � <br />.._....—.._Urinal � . , <br />..-Z.......Plain Amcet insidc <br />..._-._....Side �vnik wus,F,i,r <br />....!........_Iloxc Uib autsidc <br />.--.-.:__.._Ilosc bib for building pm7�osas <br />.._-..-.-.........linse bi4 in^ide <br />-__ <br />.-......_..._I3ib far stnble cmtaining.........._....... stnil � <br />.._......_ __.. <br />....---.....A'mubcr ot pers�ns in fnrt�ily <br />'�- NumLer of rooms in Luilding <br />T.ie premiacs nrc to bc used ns n .� <br />/ , <br />1'hc otvncr ot the prc�nises is ..(�' •� <br />.. ����..... <br />Thcngcut is........_..._........_ ..............__... <br />. ............_.. <br />.._ ........................._..............__._.. <br />Thi.a npplicntion, nithon�h siFned, shn11 not bc Linding upon thc City until <br />nccepted by Lhe Superintena/c�nt ot :he \Vote/r D� parim� <br />Signed... _ L.rj.....l�.......2L.V. �-L� � C'/ <br />/ <br />...... ADPIi nt <br />Accepted..__._�..�.. - � <br />. . ...... ........ <br />.._.....132. . , <br />By_ _ ._ _- <br />- � . ...._ ............ ......... <br />, - 7i�'./r Superintendent <br />