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.-ti�/TL C�_ye � �-�r� <br /> _ � . . <br /> H'. �. Form 4 I500 ]-I-17 C.P. <br /> CITY OF EVERETT�=Water Department <br /> Application for Water <br /> AII blanks must bc filled in or crosscd aut <br /> Everet4__ '...___"___.'. �-Q�91y.Y <br /> TO THE SUPIiRINTENUIiN'f OF TIIE NAT IiPARTMEN7'. . <br /> C17'Y O� E`1FR TT: <br /> 1 hereby apPb'���r the uu o(wa�er in :�ccordance w:th thc rules nnd requla� <br /> tiun,o(Thc 1Vater UeP�rtm�n1,fur Purpnses :md fistures stated bclmv. <br /> Durinq the timr ihat any�(thc«'�ter mains mny be taken up by reason��f <br /> :my iinPrm�emcnts auUwrized by the Cilv n(Ererett.in or of nny strcct ��r a11cY in <br /> �vhich theY ����Y have bcen laid, the Citr will nol be rcquircd to lurnish water durinR <br /> �he prugress of such impm�'�'meNs lo am consnnter H'hose supp�p ma)'�hus be cut <br /> ufL or bc liable for an���y JJJdnm�Kes far its failurc�a tn Ja. <br /> Aoplirnlian N����� . A�.�,� � � <br /> . �-__/'_' 1dn {�✓�-�'^'�"_,- <br /> 6luck _Z_� '_ . __Lnt._ _�._______.__'_' ✓ <br /> /�z_�-- �,��v_.N.'�f'._....__'__Strect <br /> No.-�_- <br /> .-._. ._.._-..___' <br /> . _____'_.____.__.'_._.____.___.____._.._._ <br /> 'I'he wnd; tu he evecuud Ly --------'---' �------'-� � --- <br /> ._._ . i'himber <br /> State sizc o(tap. 1 � �. e o <br /> ����__Tnp tn lK•inserted in Ihe main. <br /> �)S <br /> '_._"'_1Yatcr dnset <br /> "__-_'_13ath �'. <br /> Y <br /> . .. ___ .Urmal r: <br /> ..______.Plnin faucct inside . . <br /> ..____.___Sidr walk aasher r : <br /> '_.____Hnse bib nutaidc �� <br /> ___"_"_"Nnse bib Gv 6uilAinH V��rPocis . <br /> / <br /> _.'_"""11nse Lib insidc . ,. �. <br /> '_l3ibforstnblecontnini�g-_--------s[all.__._---' . <br /> . __ __".Numbcro(personsintamil7 . <br /> ""____"Number��f ronms in building <br /> _"'______'"'_'"_ <br /> "'_'"_'___ <br /> " <br /> The prenuses are tn �c usei �. � ----� <br /> The mvner o(ihe Premises is .___...-___.__.._.-_._ <br /> -._'_____'___"_'-' <br /> I � _ - - . , � ThcaKentis '__'.___'.._. __'_._..__." '._._.._._.___'_.._______.'_._ <br /> . .4is application,alUiouRh signed,sh�ll not bc binding upon the CiIY, until ac <br /> . •d by The SuperiNendcnt n thc 1Sn1 " //»t��rUnen!t�. _ <br /> SimeJ'_'�� `"�/-- '�1i�ApPlicant <br /> .�._ _..___. <br /> . — � R �� ��r_y—"�_� _____._"__"___- <br /> � � pMe�icd. .-'��-'_' 1J12. 5'-�j',C /'- s�r.�im��nem <br /> V <br /> �� <br /> ..c_.- <br /> _ __""� <br />