Laserfiche WebLink
'�.,.'-b. � . 9 � 2 2 � "1 �i <br />\\'. D. Form 4-160�—E.P.Cu.-6-2G-2A <br />City of Evexett�--�J�ter Department <br />APPLICA�'ION FOR �ATER <br />�lll Ula�ilcs roust Ue filled in or crossed out <br />Q��. '� . _1�?�.:.. <br />Eeerett� ..............._.__.._.._...._........A..... �..::..._._. ... <br />A <br />TO TIIF, SUl'IiI2IP;TENllENT OR TIIG \CATI:R DEPAR�f1iG\'C: <br />C1TY OI�' LVEIt1;TT: <br />7 herebp aPPI}' for the use oC water in nceordance �rith the rules imd 7'egu- <br />tations ut the Natcr Department, tor purpusus +md iisrures stated helu�v. <br />Dnring lhe time thnt n��y oC the �cater mains may be tnkcn up by renson <br />of any imPi•��veuicnts uuthorized Ly thc City of Lverett, in or of nny slrect or <br />nlley in which !hey m.ty hnve becn I:�id, l6c City will not bc required to furuis-li <br />�vater during tLe P�'�6�'ess o[ such improventents to nny consumer whose supply <br />utay thus be cut off, or be linble tor :my dmnages for its Cailure so to tlo. <br />Applicntion No.........c%.Z..d�.I � 'I /`I `/ <br />� 7.�- � <br />Blodc..... ....... _........._... Lot...`-.2 ................._...... Add..___.____..._'_._.___.__. <br />No.........I...�.�....I�.__..�.._..L.�I....�.�.�--� ...................._.Street . <br />.__......_ . ... ....... . . ..... ........... Y �`. __ ... .. ........._. <br />The «•arlc to 6e executed bl' .. - . ' �� � .. .. .- -. PlumUer <br />State aize of tup. <br />_��...��.._TnP to Ue inserted in the main. <br />._,..I_... iPntrr closet <br />�.........una, <br />�J <br />, I �',_. <br />� ' ��P <br />, � <br />----.-.:Urinul f`�� �y,y� <br />� ....Plnin faucet im;ide �•"`� '� <br />✓" <br />...—.—�.._Sidc tenik W:iSI'.CF /�, � � �Qy- . <br />..._Hasc bib outside /� � � ;�P <br />/ �t� � <br />..... .__IIuse Uib for building putposey/ �y�� <br />.....Iiose bib insidc � � <br />'--- <br />................Bib for stnblc contninin�......._..........slnll......___........ <br />_ - <br />_..._..........NumLcr uf persans in fnniily <br />._..�.....Numbcr o[ roonts in building ' <br />�he premises are to be used ns n._ .... . ._ .. ..._.._..... <br />.���� o��•ner af the prer.iises is�.._ .. ���C�'�.�`'t-'t� <br />��:.it is .......................................:........__..._.._....._._......................._..................... <br />��: ..•�plicntion, nithuugG signed, shall ot be Uindi g upon the until <br />'. the Superintyy/q,JcI��'n��t �oC the Nn r Depar i <br />' � Signed......._F/.v!^(%'...�._ ._._..._G� .... . ................_Applicnnt�. <br />Accepted_...__lL... . �..�.��. ...1;12� BY..... � ... ... �.ifl / ........ . ............ <br />, I - / Superintendent <br />N <br />