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��-� ii-y�zs-'3:/_ �.�,l.u�-�� �-�- ,. >"'�7; <br />N. n. Fo.m l- li�no—E.r.Co.—G:6�^.� <br />City of �verett--Wnter D�partineiit <br />APPLICATIQN FOR WATER <br />Nl bl�nl:a nmst Lc f�!Ird i� or crns�ed out <br />P:vcrct�. C.<f�: ../ .J...._�......_...........1nY>.5. <br />TO TIIE SUI'liRItiTENUENT OI' Tlili N':.TEIt I�L�PART.\ili\T: <br />CITY' OC' 1'sVE1;ET'P: <br />I heicbp nPply for thc u�.o of ��:;tcr in :�ccm�d:�.m�c tcith lhc rulcs and reB�- <br />la��nna of thc WaLer Deparlment, for pwp��=es :md iis�ures staic:l bclow. <br />Puring ihc time thnt any of tl�c tcaler main� may Uc lal:en uP Ly rcason <br />of nn>' impro:ements euthorirrd Ly tLe Cilp of F.verett, in or of an1' =lmo6 or <br />nlley in which they rna�; hace bern laid, lUe Cily a�ill noL be requireJ to furnish <br />�eater dm�in� Uie pro� iess ot such impmvements ta any cunsumer whose suppll' <br />in;rv th�s Lc eut atf, o' bc li:�blc fnr nuy dam+�gcs tor its fnilure so lo do, <br />Applicnlinn 1Go.._�2..�.� ............... <br />131ock.. __ .'.�. // _...._..... Lot.. `�01� e`Z 3..... Add... _. __.... . __. ._. <br />Nu....___. a. Qf .% __� � . Lt *L.� . .......Strect <br />._ . . _.. ....___... <br />. .._...... . .._ � l <br />_. . . _ . .... . .... . . .. . / � <br />fh�. worL' to oe executel li�../�/ . •. /�'c.�c.` <')......PlumLer <br />1T -[ � <br />S�t�ate si:e of inP• ,/- �r � � -- <br />7., <br />.J.7_......Tap lo Uc inscrted in Uie main. <br />_.../.........R'uicr cloe.et <br />_. �:........ llath � <br />�._ . <br />. ._...........Urmn <br />._.%.:.......Plain l.��cc' i:...idc ._" <br />..._-........Sidc tcall: trnshcr . . "' <br />.._�....._...liuse Uib oulsidc " . <br />_.".-�........_llose 6ib Lur building purpo�es <br />�. ._ ..Ilasc ��iU insidc <br />._.'.:...._...11ib for stnUle conlnining........._..._....stall...........__..... <br />......`.......KumUcr ot persons in fnmily <br />....f......NumUcr of rooms in Luild[ng j,-� <br />7lic premises are to bc used ns a.-.. _---��� .�Q�:� -- � <br />. . L�. ' �/.1._._.�a[.��, �_�. <br />l'he o�vner of lhe Prcr.uecs ts...y.: . ,/ ..•....{- �. f�� <br />/ l_ � <br />7� -......._... _......._.. <br />The a�ent is.........._ ..................... ...(..�..__.............................._......._..... <br />. . . .............. <br />iis npplicdion, nithnugh signed, ::hnll not 6c binding upon thc Cily, until <br />�4 6^ the Superintc 1 rt of lhe V�1cr Uepnthmrnt,` <br />�� � ..._ . � � � .��. -� .. APPlicnnt <br />S�6ned�.�_ ��� �� 7 <br />_ .. . _.... ../ <br />..�....... � _ �.... <br />� -ii -'� IIS ...������""�,,.upc_mtendent <br />7" <br />