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' " v : re 9t"- /)f � 'I y <br /> ' ' '-�-��+1'—A — � ' I'O - lS (.'`>"✓V <br /> W.D.Form��-IGoO—E,p.Co.-6-26.21 • . <br /> City of Everett�Water Department , <br /> 1SPPLICATION FOR WATER <br /> All 6lnnks must ba filled in or croseed out I <br /> Evcrett,........_�,�.0� <br /> .... ..1...5................................19P...... <br /> TO THE SUI'ERINTLNDENT OR THF, p/ATM:R DEPAItTHENY: <br /> CITY OP EV3ItETT; <br /> I hereby npply for the usu ut wuler i�i nccordnncn with the rulee onJ reQu- <br /> lationn ot the W¢ter Depnrtmenl, tor pm�p��rey nnd fizturce ytoted betuw. <br /> Dudng lhc t(me thet any ot the wnt er maina mny be tnken up by renaon <br /> o[ any (mprovemente eulhorized hy the Ci�y ot Everett, in or o[ eny etreet or <br /> elley In �vhtch they mny hevo been Inid, th� Clty will not be required to furn(ah <br /> wnter during the progrexe of euch (mprove�nenln to nny co�ixumer whaee eupply <br /> maY thux be cut off, or bc IIuLI for uny dmm�ges for ite Lnllure eo lo do. <br /> Al;plicutlon No...�l.o��................ <br /> Qloek..rGC,;ai � <br /> �.Gt.,lty' Lot...................... . . Add. <br /> . ............ <br /> . _...... ..__..... <br /> _ . ...._.._. . ..... <br /> No...�3..G U...__. �,i. GS�I�.....................9treet <br /> __ _.................. <br /> ...................... <br /> . ............... ............. ... <br /> .....__.... <br /> The wor� ta be executed by._(�`U.��y���A A <br /> Stato elze at tap. � �� �-�����_�"Q��?��`��umber <br />' ..y�2....�.Tap to be ineerted in the mala j 3 ' <br /> •��-��.........R'nter claset . <br /> .....�.........Deth <br /> ......`......Urinal <br />�I Z.......Plnin tuucet Inelde <br />, .....,c......SiJo walk waxhcr <br /> •.....L......Iioxc hib nutntdc <br /> •��—��.:.._Hoae bfb fat LuilJing p�upoaee � <br /> •-�..�....Iloee blb Ineldo � � <br /> � <br /> ...-�-.::..Bib for etable containing....................elell............._..... <br /> •����!:...::..Number ot pereone In fnmfly <br /> �����-�...Nmnbcr of roome in building <br /> The prcndeee are to be useJ ae n........_�„����� <br /> � ��-................ <br /> '�'b^ ox�ner of the premieee in.. ...... <br /> __. .. __.._.... ................. <br /> �:�, .�gent Ie..................Q . ��.�C'i�[ .... �............ <br /> . .......... <br /> a�� llcndon, althou h ei ���"�"' <br /> R �ined, ahnll nat be Llnding upon tho City, undl I <br /> � �� the Superinten�ent of l4e Wut r Dep�rtme <br /> 1 n �/ . <br /> j Slgned.. . ........(l....................... �G'��� „ pp cant <br /> �/< /. <br /> .................:......... <br /> . . A <br /> , �_'r,� — - ��.... .. � If <br /> ,19� By ... � ' <br /> � �� <br /> � .. .:. ... ...... <br /> v uperintendent <br />