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_ • .. � . . ._ . . . � . . .�. � <br /> � <br /> :- !— .� '-. ,_ � L .. - . . . . <br /> '��'. D. Form 1 I500 J-I-I I G.P. ' <br /> CITV OF EVERETT==Water Departinent <br /> Application for Water <br /> .qll blanks must be filled in nr cro=_sed uu[ <br /> �J �� ' <br /> ISverMl. __-_:l��%�-u-G<!�—_. '______ _1V�_�7/ <br /> 'I'O 'PHE SUPBRINTEYUI3N"C OF 7'Hii NATER DEPAkTriGN"I'. <br /> �17'Y OF' G9ER8TT: <br /> I hereby apply for the use o(•a�a[er in accnrdance with the rule,:md regula� <br /> ti�.ins u(The Natcr Uepartm_nt. fnr Furposes and fixWres slaled bclmv. <br /> Uuring [he [ime that any of�he watcr mains may 6e tnken up by rcason o( <br /> :mv nupruvumenu au[liorized by [iie City uC Gveret[,in ur u( any slrcct ur nlley in <br /> whici� �heY �����y have Lcen Lud. the CitS' w'ill no[6c required to lurnieh water Auring <br /> the proqress uf sueh impruvemenls to any consumer whnse supply may Nius be rut <br /> n((.ar 6e IiaUlc for any dam;igc�,J(or its f�ilure so�n do. <br /> Applicntion No._�_�`�__�. /__._____ <br /> filuck .__ '_�_(_' __ _�Lo _____Add . _ .. . <br /> p / ___'___'_____ <br /> \n..___���_Q. '_�..c"a:�!___""'.Strc��t <br /> 'fheworktobeexecutedbY___._'_________ '___._______..____ . . . Plumbcr <br /> Sta[e siac ut tap. <br /> �/�y.Tap to bc insrrb•d in Lhc main. oU <br /> ______.Wntercluset � /� �-- �'. <br /> _.__...Bath <br /> . . . --__ .Urinal <br /> __.-_-"Plain faucc� insidc <br /> .____.Side walk wasLcr <br /> ____-____Hose bib uutside <br /> ____ __Hnschibforbuildingpurpnsev <br /> __.___..Hosc bib inside � <br /> ____'____RibtorsL•�blecontainin{;-'___.- . ..st:Jl ._ ___" � <br /> ..__'/_Numbcro(persunsinfamily <br /> .___F_-__Number o(rooms in building <br /> 7'hepremisesaretubeusedasa.._. ...._ . __ .. .._. . . __ . _.. <br /> 7'he owner of Ihe Premises is ___._____. _.. .. - _. .._. _. <br /> ThcaF'entis.. '__..____._.. __.'..___.___ . _ .._ ______.__- <br /> "I'his applicatiun,although signrd, shall not be binding upnn thc City, imtil ao <br /> cepted by 1'he Superintendent u(thc 1/Vnter Deparin.en//L / <br /> Signed_.C/_�:�`-�"6.-__�L�"'�'.�'v._/l___ .__Applieant <br /> ,,,<<•„«<i /'.� -z� --ie��nr �� '�1 <br /> , ;�,�-����,��:��, <br /> � <br /> �. <br />