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�H'r7j6-Iy-)LN,' FvJ"/ .r.. r 1f_—i.Lfl. <br /> ` ` <br /> W. D. Form t I500 3-1-1]C.F. � <br /> CITY OF EVERETTm=Water Department <br /> Application for Water <br /> All blankx must 6c filled in or crassed uut <br /> 1?vcrol�....-- . `-<_'-.-�'J-'---'---'�°� -� <br /> 'PO 'I'HL' SUPIiRIN7'F:NUIiN'1'OP 7'IIE WATL'R UGP:\R7T11iN7'. <br /> CI"CY Of P.7ERL"PT: <br /> 1 hrreb��apply Lrc the use of�ca�er in acc„rdanm��'ith tUe rules and re{;ida� <br /> timr uf The \V:iter Daparlm�nt. for pur�nsc; :md (isuucs stateJ bclou•. <br /> DurinH [hc timc that eny ni thc wa�er mains mar bc ukcn up by reasnn of <br /> anv imnrnrrments authoriud br the l'iq�o(Ecerett,in or of any sucet or nlle>' iu <br /> which�hcy nn9 have been laid, th:l'itc �vill nut be nquired tu(urnish v:rtrr durine <br /> ihe Pru�;ress n(such imprortments tn anc cuusumer whnse c:�pply n+�a tims be cut <br /> uff,or be Iiabic fnr:my da�nngcs tar it. Gilure so tn du. <br /> APPlirntion No...-��_.��._'_ �j <br /> Rluck _/1/ �.7J .._1at.....�.l."--�.-�..Add_"_' --__""'-- .. <br /> \n."'�Y�� y._✓U�'�'�-�'[.�.'_'_Strccl <br /> ___'_'__..._'_.'.'_' "'__'_'_ p_"/'J. _ / '_"'_' <br /> _"__"'_"_" _""' <br /> 'fhe�ra�kla6cexecuted6y_.C�_�•__��`.t� .�l/�+�G- A"�dJ-.— Plumber <br /> Slalc m nElap. �Q � <br /> � ) � <br /> ..��'_"Pnp tn bc inscrteJ in thc main. I <br /> ___�-14atcr dnset <br /> -'-'_�"IIaU� � <br /> ... .-- .�7rinal <br /> _.'__'_Plain fauret inside � <br /> ,,L <br /> . ._"._Sidc�calk �cashcr <br /> ...__"._Hnse 6ib oulsidc <br /> ._'_""Hnsr 6ib(orSuilding purposcs <br /> .________I losc bib insiJc . <br /> . ""' --Ifib(o(sla6lccontaipinF...'__"'"_slall"".___'" <br /> f __'. _'NumLcr rf persnns in (amily � <br /> _._'6_'Numhcr o(raam.in huildinq . <br /> "ChcUremisesarembeusedasa' .__ "'_""_'__-__- __""_- ".... <br /> "Phc •,wncr a(thc Prrnti=es is .___-"'__'__'_'_-_-___' <br /> Thea6ent is _._'_..__ .... _ _"._"____' _"__"'__' , <br /> 7'his applitation.nlUiough siKnnl, shall rul bc bindin�;up��n �he l'ilY� until ac <br /> tepted 6y'Phe SuperintendenLyf�h�Nntcr N����nmcnL i <br /> � � . <br /> Signed _ ..-,__!�_-_��'�yt�- . T1__A �licant � <br /> _� �� PI <br /> Arecpled. .��' ' =�""11��- By_ � i: <br /> _�.- " <br /> -' _'____ _...'__."____ <br /> ,-ii:•.i..inrn• � <br />