Laserfiche WebLink
� <br /> i <br /> '.�Av-s4 ���-;r '_ <br /> �_., ; _ . . . ,� <br /> � . <br /> . 'tv.U.Form4--]r�ao—I:.CCo.—L.:G:+ <br /> City of ��verett-��Jater Department <br /> APPT�,iCAT�ON FOR W1',TER � <br /> All 6L•uiks inusL be fillcd in or crossed out <br /> livmrott..............._��/......�. ...ci� � _........195../.. • <br /> TO Ti.�" " "'Y�RINTPNDENI' OR TIIr NATER D.'AP,T`(��'i`• <br /> CITY Or �VEP.liTT: <br /> 'reb's �DP�Y for the usc oC wntcr in :u•cardancc with thc rules and regu- <br /> latiuns f the \Putm� Department, for Pm7�oses ��.nd fiXtures stcted belom. <br /> � TJuring the time thnt nny of Lhe watcr muins may Ue tnken up Ly renson <br /> of an1' ��nProecments authurizcd by the City of Ecerett, in ar of any street or <br /> ulley in which thcy mny hace hcen lnid, the City �vill not be required to furnish <br /> wnter dm•ing lhe progress of such improcements to nny consumer �vhose suPply <br /> m;�y tLus be cuL off, or pbc�ljia/ble for any damuges for its failure so to do. <br /> ApPlication ?�o.._..0.../..f7._:3............. d ZO z � <br /> Block....................��..G�........_ Lot.._'....x/ . Add.......___.._...._.__..._......... <br /> . ....................... <br /> .J� � / — � � <br /> No................i......�.�. .........._..........�`�... .:.:........................Street <br /> ._._..._...,......... �.�........._................. ...._... ......... <br /> ..................._............................... . . � .. . ..... <br /> Thc �vork to bc executed by�...L;liLt-GGv�r-!�..�.� �/.... .. lumber -� <br /> � <br /> State size of tap. � �� %��� -- F <br /> � <br /> ..��� Tnp to bo insected in thc ma�n .,f� J � � �� 7 i �� <br /> i ; <br /> .. � ....��'ntcr closet � � � <br /> .....L.......Bnth cm n �IAY � i �U�.q i. <br /> ' � � t:,:i <br /> _....... x1 wnt�.� no.,,; <br /> ........�....Urinnl : �i ,� . <br /> ._..2:.-'--Plnin f,mceb iuside /... . ........ . � <br /> ....... ......Side walk wnsher <br /> .....�.........I�Iose Uib ouLsidc � <br /> ..__—.......Aose bib for building purposes <br /> ......—......Flose bib insidc <br /> ...._-.......Eib for sl�ble cantaining__...............stnll.................._ �.. <br /> ..... ........IQumbm� uf persons in family � <br /> .....,�..Number of rooms in Uuilding /` <br /> The premises nre to be used as a._ . _U.�2�...........{..�........ ..._................._... <br /> Thc owner of the prer.iises is. .. _�iti.<c4:�:tJ...__../.:,7...L!!+./L{iyt <br /> The ;�gent is............................................................................................................ <br /> 'fhis npplication, although signed, chall f.o�e binding upon the Cit until <br /> �ep� :d by the SuP� a ,te/ndent/of the Nater pnrtment. � , <br /> Signed.. ....Yl�/��...... ._.�i�i/l.F�. .l..�.....Ap Hcun �,� <br /> l�t�d..��..'.- ..�...,.—....192� Dy..........��.E!�.:�..�„��y�t�;d�.*'�- <br /> / S�r . <br /> l <br />