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� ._.rr� N— /9—�-e1� <br /> W. D. Form { I500 J-1-17 C.P. � ' . - � � <br /> CITY OF EVERETT-=Water Department <br /> Application for Water <br /> All blanks must be filled in ar cros e t �t <br /> E��erett...___. ' '_'_/�_'..."__"'_'_19Y���__ . <br /> TO 7'HE SUPERINTENDENT OF T WATER DEPARTMENT, <br /> CI7'Y OF E7ERETT: � <br /> f hereby apply [�r the use o(water in acconlance�vith ihe mles and regula• <br /> ;inns of The N'a[er U:partm_nl,(or puq�nses and fixtures stated below. ' <br /> During the time lha[any ot the water mains may be taken up by reasnn of <br /> any improvemen[s authorized by thc Cirv ot Everett,in or of any street nr alley in <br /> which they may have Uecn laid, thc City will not bc required m fumish water during <br /> the proRresa of eu[h improvements to:my consumer whose supph• may lhus be cut <br /> n((,ur be liable(or any�:�agcs t¢Cits failure so to do. <br /> f . � <br /> Applicntinn No..J_"'U <br /> "_"""" <br /> / <br /> Rlock .----""'- ----_Lotc-'----------'---"'Add-----'------'---- <br /> Nn."_'�/�O �' �_"""'"..Strcet <br /> _ "_"__'__C'G""'_' <br /> '__"_"'"" ' ___'__""'_""__""""" <br /> .---,fhe work to Ac ezecu�ed by._"".____""'_'_'______"'__"'___"' Plumber <br /> Statc s e ut tnp. <br /> / <br /> .__�'2C.Tap ro be inserted in the main. <br /> '___"_'_'W�Icrdosel �/ � o�o . � <br /> _""'__[lalh . ""`_•, ��.. <br /> . .Urinnl ;'�\\"�'"'•---•-.�'L.\ <br /> �� <br /> ��__._____Plain faucet insidc � ; .',[A�t �If� a�,c <br /> ' "_'_"'Sidewnikwashcr ' '/�'tilrll�l'1 '�i-1, <br /> 11 <br /> __._ <br /> .._Hose hib outsiUe ���(� �- I <br /> • � ' � � I <br /> .__"'-_..Hosebibtnrbuildin�;pm�pnscs ///'''��� ::� 1 ��. <br /> ________'_Hnsc 6ib inside � (� Per�• <br /> . . � / , <br /> ._"""' Ilibforstablecontaimng._'.____._slall_�S, . , <br /> _'._.�_..Numbcr oC persons in tamilp @l+ �e,/ <br /> +w, . <br /> __��_"'Nnmbcr o(ronms in buildinq <br /> The Premiscs are to be used ac n..__.__""""_"""""""___"' '__"' <br /> TLe o�vnerof thepremisesis ._"'._.--"---.--------------'-'-'_"_'______ <br /> TheaHcntis '_".____"'.___.'."'_____' "-_-._._."._"__'_.___"'__'___ <br /> Tl�is application,nithouKh siqned.shall rol bc binding upou thc Ciq•, �mtil ac- <br /> cepled 6)'Thr SuperiNendent of ihr�"..'�- Ocpariment. /�- , <br /> �'1i�iL7' (�'V�-".Applicant <br /> SiRncd'_ __' "_' "=F"4(� <br /> ""_ <br /> !i -�—� � <br /> . <br /> n«ev« — -'�- ---��' ' �`�__--- --- --- ------ <br /> /- , s,�r<<�:�i��n«.� <br /> � ' �'� <br /> � <br /> o-r ' <br />