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�,,.'8':; i•:-�; ,,� <br />L+NTJ> �!-✓_�. �, � <br />� R'. D: F',rm { I500 J-1-17 G. P. ✓ <br />CITY OF EVERETT�=Water Department <br />AppYication for Water <br />All 6lanks muat bc fillcd in or n�ossed t <br />� <br />hi <br />F:vcrelt.__'.___'__ _"J"�_�'_____"_19Y'�_' <br />TO THE SUPF.RINTENUIiN'1' OF THg TF.R DEPARTDIENT, <br />C17'Y OF ti7ENF.TT: <br />I hereh>' aPplylnr the use o( water in accordance with the niles and reRula� <br />�i�.ci� of "1'he Natcr Ucparun^nt. tor purpnses and fizmres stared below. <br />DurinR the tinm Ihat any nf Utr water mains mnr 6e tnken up by re�son o( <br />any �mprovemenls. authnrized bp the Citc o( Everelt, in ur nf any sucet nr alley in <br />�chich thry may have been laid, the City will nul be reqnircd ln fumish waler durir.g <br />Ihe prngress n( such imprnvements tn any conswner who<e supnly may �hus Le cul <br />nfi, or Ue Iia61e tnr any dam�:y�ges fur ils failurc so �n Jn. <br />ApplicnlianNo..�'�./.�__'___ �y��. n (� � <br />��' � '__ I Q/ie�-<..t"aC�.!'.r���..t;.��� <br />Bl�xk �/j �.}-�� �- -,-� L�ot�----�-,-L'--------------Add r, <br />Nn._. �`/_".CT". f,�v�wN__._'.__'____..Sircct <br />_._'..____.___'__ ' ___'_____.__._._______.__"._____.___._____.___"_ <br />'fhewnrklnbecxecuted6y..___.__________.___._____--___. Plumber <br />Statesi pftap. ��_ <br />3 / _.- o0 <br />7 Tap tn be inserted ;n the md11 �_;ti��" � / O_— <br />tV���r �����..e . � ���•.���4 0 <br />-------. n,w <br />._. ._._ .Urinal <br />.--______Ylain (aucet insid <br />__..___Side walk w•asher <br />� � i-� '' . �r; , <br />����� ����������; <br />�, <br />—. <br />' _ _ _' _'..Hnse bib oulsidr \ ` ^f _, .,-.. - <br />\;. ' r <br />� <br />N"� <br />..___._.Hnscbibforbuilding�iNYpi�es. ;..'. <br />- -. <br />. . _ _ _ _ Hosc bib insidc ��' ' _ . •' <br />. , <br />�:..: . .... - <br />_"_'_.._liibfarstablecmn�ining._._'_'_..slall.._ __. <br />' _ _ . _ _ _ Numb:r af persnns in (amil}• <br />._.____'__Numbcr o( rooms in building <br />�. 'Phepremisesaretobrusedasa____. _______.____.___._..__ <br />....__ .___'. <br />7'he mvner af Ute premises is ______ ______ ___ _ <br />. . _ _....'_'_'__..."___."'_ <br />'fhcagentis."_""_"'_'_"__'__"_ '__. <br />This applicntinn. allho� � siqned, shall nu� br bin mg upun the Ciq� until ae� <br />repled hy The Superin�en ent of the N cr Uepzrtm�nl. , <br />SiFnn _ ""'_" _""__"___' . . <br />�t� <br />Areeple< .��"" j�j I3�_'"'-"'_...._____'___ <br />� sim.ri�irnirni <br />