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I <br />� <br />� <br /> �N7%J E —2 3-19 ��� <br /> � 9- �+ _-,, , <br /> ., <br /> � '��t�. o. Fo�r� a isoo �:-n c.P. <br /> CITY OF EVERETT==Water Department <br /> — <br />'j Application fc�r Water <br /> All hlanks must be filled in or crnss nu[ <br /> I� �z 3 ---- .t�� S <br />� ���.�u, - --------- ---- <br /> I TO THE SUPIiRIVTENUEN'I'OtY�;Yl�r Fy�RE77�AxTMENT, <br /> 1 herebY�VV�Y (��r the u+e nf�rater iu :�ccordance aith the rules nnd ngul;r <br /> tinna o(Thc Watcr UrP�rUn�m!. G�r purP^'es nnJ fixtures statcd bcirnv. <br /> Dnring the time ihai :mr ot the��•:ter mains mac br tnken uP by reason ot <br /> :my imPrm•emrnts authorized hy lhr Cil? o`Evcrett.in or o( anY strcet or aIIcY in <br /> the P�H�ess m�such impmvemertn to nnY consumerrcW hosc'supply�Sna) ihus berra <br /> uff.nr be li�ble for anY damages(��r ils failure<n ro do. <br /> APplicntion Na.__�II�-"'--- / <br /> _�_'_"""Add_".�!��'a-.t����--) <br /> xi�k ._��7 - .--..i.�,� �-9 ",2. i <br /> / o o_G_..C�_,e�'a --at-�^C�:--_..s�r��c <br /> ;.,�.._. - - <br /> ---- <br /> - ----- <br /> - -- ----------------- - --- -- --- <br /> _._. <br /> ...__-_ ___-.___ Plumber <br /> "__ <br /> ".' <br /> '1'he work to be execute y'----' <br /> '_""" _"'_._" <br /> Stn�e ci2r��f t�P. � <br /> Tap to be inscrlcd in Ihc main. ° <br /> / � � ' <br /> -Iy__" � g <br /> ___�-___1Vatcr clasel 2 <br /> ___�__'__I3alh <br /> Urinal <br /> �-� ___._.l'lainfnucetinsidc <br /> . "____-"�If�C WO��(N:IphCf . <br /> '_'__Huse 6ib outside � �` <br /> .____..IloscbibfnrbaildingPnrpo<cs .:,� , � .:. .• <br /> _._____'_Husebil,insidr . . '`.. . . <br /> _slall..'__'''_" •. <br /> ___"'__'_Ri6torst�bleconlaining—.----�— � <br /> ___.\wnber nf P�rsuns in famil�. <br /> ._.5____'NumUer uf rnnms in bnitdinK <br /> "1'hc Premiscs arc tu bc used ac a___..___.____"_._.'... <br /> __'.___..___ '_._. <br /> 'Phe na•ner u(�hc Premisrs' is '___"""'-"'_-" <br /> __..___.___._ __.__".__'_. <br /> Thcatientis _'_'____.__..'_._'___'__'_ _..__._ .'__.. <br /> ""'___"'__""' <br /> This applicalion,although signed,shall not be biuding upon the Ciry, until ar <br /> crpted by"Phc Supci6uendent o(iLe Na��DeParfmrM. � __- .. <br /> ' '":ii�. •��� �'L�117'_"_ApPlicant <br /> SiNned._.'_._. _'__ <br /> -_.:__. <br /> �.� H�•_� '-" <br /> /� ' ' "_.'___'_'_"'_"_'_ <br /> AeeeptM(� -`'-1- "-"' �/ Suverlmm�iem <br /> / <br /> I <br /> � <br /> � <br /> � <br />