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E,'i r _ -, , . : <br />- +r"� - � •, ._ �.- .. . �-J.,, <br />K'. U. Fo�m ♦ I500 d-I- V C. P. <br />�ITY OF EVCRETT==Water Departmznl: <br />Application► f�r Water <br />.411 blanks must bc fillcd in or crnssed out � <br />✓�/ � � R <br />Evereu.... ______________'/__`G. _'________19�-�__ <br />'I'O 7'HE SUPIiRIN'f6NDENP OF TIiE WATLR DLPdRTniBRT, <br />C�7•y qF E'/IiRE7'1': <br />1 here!iy apply fur the'use ��( �'+��ter in :iccordance �ei[h the rules anA reF�:la� <br />�iun: o( The PJ:iter Uepartm�nt. for P��rpns-es and itxtures stated below. <br />Dur;n; Uic time iSat anp uf �he watcr mains may be ta'.en up Ly reason of <br />:u�� improoements authorized bp Ihe Cil�� oi Evrrctt. in or of any slrce[ ��r alic}' in <br />w::ich ;!:r, m;iy have been laid. ti�c Cit>' «'ili no[ b.: nquired ;n furnish water during <br />the progress o( yuch improvrments tu any consumrr whuse supply mae �hus be cut <br />0!1, n� be liahle tor any dam:ipes fur its L�ilive so to da. <br />Applicn[ionNo.'�G ��'_"__" , / <br />131nck ____; ' _____Lut_._/� _'_'__'_'_'_AJJ... _' . <br />- __... _._ ._. <br />\a---��0 �—. .-/�—� _-_'__ _.. _ __ __ _ SVie[ <br />'Che wnrk in bc rxecuted by .-----'----- -- __.___ _ -_ �_ �-��__ Ylumber <br />Statc yiu o( tap. <br />� /� / ScIG <br />--,�-�'-Tap to be inserted in thc main. \7X �, � <br />7j <br />-----/-__1Vater clo=et <br />__'I_'__I3:�th <br />__. ___ _Urinal <br />---.--__Plain (:iucet insidc - <br />------,_SiAr x•alk washer .. <br />--------..Ilme bib outsidc <br />-----_..Husc bib (nrbuilding P:�.rpnses � (, <br />.._. <br />..."—__Hnsc 6ib insidc '..' . <br />. ___"_'__.Qib for slable cuntnininF.--... -_ --.. `talL ... <br />-_- �y/Numuerofpersansinf�mily . .__- <br />-----=/___Numbcr nf rooms in building <br />7�he premises are tu be used as' a_____ ________'_.___.-. <br />_'._.__.__._ _.._.' <br />"1'homcnern(Ihepremisesis _'_'_'_________._. <br />.__.____...._____'-____. <br />'Chcagentis.--- ._--'-'-----------_-- <br />. .._.-.. .'__'_'_"'________'____ <br />'Chis application, ahhou�;h si�ned, shall nnt bc bindinK upun thc Cily, until ao <br />; eptcd by The Superimenden[ o( i� N ter U�r/p"anment. � <br />�.�'�J�/�{�> i� �l. <br />Signed'_'.;'/__ ._" -!/<f_�L�.%„/. _ <br />i Appikant <br />.lceepted_�_ .�_ . .18�.� By_.�-__ ��. <br />�_ , ' _'_'_... _.__. <br />. . �Snt•�rimenncm <br />