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_ �n�rv �-rv za �, <br />. . `--'�'�' 3-'+ -S-rJf <br />N'. D. Fnem a 15G0 d I-17G. P. <br />CITY OF EVERETT-=Water Department <br />Application for Wat/�er <br />All blankc must Im filled in o� cm. d nu� // <br />i �i <br />!�� <br />Everrtt. � �_.___19�/� <br />--__ _._____'__'___._'_ ' <br />TO 'PHE SUPF.RIN7'F.NUEN7' OF THE WATER DEPAK7AtENT, <br />CI7'Y OF' EYERETT: <br />I hereliy apPIY (nr tl�e use u( wa(er in :�ccordance wi[h Ihe rulec and reK�ila- <br />tinn, uf The W:�rer Departm-nl, (or purpnsrs and fixtures statcd belaw. <br />DurinK the time that am� o( the watrr m:�ins mnr he taken up hy reason of <br />any impmvemenls aulhurized hp the Cit�• n! Everrt[, in m of nnp strcet ar allry in <br />wluch ehcy maY have Lcrn laid ihe CiIS �}'iii i�.rt be required In lurnish wahr during <br />Ihe pmFress nf euch improvements to anv cnnsumrr x�hnse supply may thus be nrt <br />nf(, ar bc linblc for any damages fnr its (ailure so lo do. <br />Applicn�ion Nu._ �'� � �' <br />�•�. ""_'__' <br />Iqack ____-..�_�' __._ o�_ __.____.'..____Add....__ _ <br />- ,. y . __._.______. <br />' ' c�yt <br />Nu._"" _t..- _'_ _ __"«?�f.�.'__..Strcct <br />.__ ..............' . ._._.____. __ _._________-_.__-_._______'__'."_'_' <br />"fhc work ta I>e rxecuteel bp.'_"_"_'_"' '_".'_ Plumber <br />"_____""' ' <br />State vizr af tap. <br />i <br />. _�'� _'PaG �n be inscrled in the main. c� <br />�Y /��o <br />'_'"_�_ W:ucrdoset � <br />_-.1-._ 13ath <br />._. .Urinal <br />. _""'Plain fnucet insiAe <br />. _' _"". Side �v�lk �cashcr <br />. ___"._Hasebibnulsidr <br />___--_Jfose bib forbwldinR Pmposcs �' 1 . <br />. _ _ . _ . _ _ _ Hosc Lib inaidr � / <br />._'_____l3ibforslahleconlaininK—_ ..___st�ll_._.. "" . . <br />_ 'Nwnbrr a( penans in f:unily. <br />. _ � _Number o( rnnme in building <br />Thc Premi.es are tu br uscd as a_.. __'_""__ _"'_' _"""""'_" <br />""" <br />l'he awner n( the premierti is "'_'.. <br />_._""'_._' "'_""_""_"" <br />'_'_' <br />ThcaKentis..._..._._ __ <br />.__._'_________ ____ ________' __...'_"""'__ <br />7'his apPlication. allhnugh siq�rd. shall nol be binding upnn Ihc CiIY� until ac <br />'sd by Thc Superimendent nl Y�• Nntc/rp/�p, rlm � <br />SiKned_'_'_'_�'_( /' [�/ .��Lf�cc��yy <br />`".--------*----�� % -� J,A�plicant <br />__. <br />Acccpied� ._.._.. . 1!11 / ' / <br />_ If)'___ . ._ .e . __"_-_'-_/ <br />- �.� �r-- 5���.,�,��.��, f <br />�- <br />