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v.�. o. F�,�:, a is,,o �_;-iv c. e. o... ._ L��.. <br />C{TY OF CVCRE�'T==1��ater Deplrtment <br />� _—_— <br />Ap�licatian for Water <br />:11I blanks must bc G)Icd in or cross�•d �mt <br />3 �' % <br />ti.rren. —�-------------�-- --- ----�---1Bt- --- <br />'Cl )'CI IG il �I'IiRIN 1'GVDIiS7' OP'I'!II{ \5'A'1'ER DF:P:112T\IIiN7', <br />C17'Y OI+ G7GRETT: <br />I here65' apply fur ihe iue n( water in nccord.mce �cith Ihe rules and regula- <br />r.��i: ,�( "I'he 1Yater Uepartmsnt. fur purposes and fix[ures sta:ed bclmv. <br />Uuring the [ime �hat any oi the wan.r mains mar be taken up by rcason of <br />:my imnrnvemects autlinrixcd 6�� thc Citv o( E��erett. in nr of mip slree[ ur allep in <br />mhich theq' ma)' have been laid. the City ���ill nnt be mquired !u (urnish water durin�; <br />�he pn��ress of such improvement; tn am cunsunu�r r��hnve supplv may �hus be i-ut <br />�df, on c� liable fur :my dam.iKes lur ita failure sn to du. <br />ApplitntiunIN/u.'_____._' _'_______ <br />I31nck _'pr.�_'�'_1'___.Lot'_� _'�_ '_ "'__'.AJd___ __ __________ _ <br />Vu.----.d-:� /-'�'----'-a2.�—�,_--..Strect <br />"1'hr work to be exauted by. _-_. _____'__ _. - <br />S[atc eize of tap. <br />/ <br />... �_: _ Pap tn be inscrled in the main. <br />_ _ _ _ L _' _ 15'tucr doset <br />-__-----liath <br />____.__. .Urinal <br />__.____-_-Plain fanmt inside <br />. ._____.Sidc walk washcr <br />_.. _ _.._Hcsc biboutsidc <br />. . _ _ _ _ _ _ _ Huse bi6 (ur building pu rpuses <br />_ _ _ _ _ _. _. Hnrc bib insidc <br />_.'____".'__ Pitmtbcr <br />_____-"_Bib(urstahlecontaininq._.___.__�tall_ ..___.. <br />.. _. -. _._.t�um6er o( persona in famil�• <br />_ _ _ �_"Numbcr of runms in building <br />"I'he premises are tu 6c used as a . .. ............... .. __-___....... .___.. <br />"I'heownero(thepremi<esis______'__'_' _.__'_____________"__ <br />Th¢agentis ___.. - _._.._.____________ ___..__..________.__..________ <br />'I'his applicatiun. although si�;ned, shall not be bindinF upun the CitY. ❑ntil no , <br />repted by "Che Superintendr.nt the AVnter Deparwea <br />'__ <br />Signed _.___.(/.� -�_�_�:-c..----.._�ipplicant <br />:1cceVled.__ e_--X""_ -"'191t/� li}.�/'" " . "'_"""Snt�rimen.:.�i <br />(/ n� - <br />