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'� ,. i <br /> . . .j..:���' P <br /> �.. <br /> T�M - '.��•N�C .1 ' �I_ • � �1'C �J�A/ <br /> ~ �� � l 11.LC.;�� . 1 <br /> N.D.Form�-1400—E.P.Co.—G-2G-2� � <br /> City of Everett�Watei� Department <br /> APPLICATION FOR WATER <br /> All binnl:s must be filled in or crossed out <br /> /! �t / <br /> i <br /> �vcret t........................................................................102.`.. <br /> TO TI�L SUP�RINTENllENT OP THE R'ATRR DEPARTHIENT: <br /> CITY OR EV�I2liTT: <br /> I hereby npply for the use of�raler in nccord�nce�•:ith the rules nnd te�u- <br /> Intions of the Nntcr lleparlment, for purpases und fixtures stated bclo�v. <br /> During the timc that any� of the �entcr mnins may Lc tnicen up by renaon <br /> of nny improcenunts nuthorized by the City of Ererelt, in or of any strect ar <br /> nCey in wl�ich lhey mny lmec bcen lnid, the City will not b� required to furnish <br /> wnter during the pirogress a[ such impro�•ements lo nny consumer whose supply . <br /> mny thua Ur cut off, or bc liable .ar :;ny dnmages for its fnilure sa to da. <br /> Applicntion No....._.................�...:.:..:...._ . <br /> Block............c�.�..�.�....(...�....... L�ot..._5�........................... Add...'.........:_.'..�....:.......:..�...... <br /> No...........1..��....0..�......Q...�-z5.�l..i.d.:.Q-.-�::}............StrceY <br /> � <br /> .................................................................................................................._............................... <br /> The work to be esecuted by............_........_......... ........_............................Plumber <br /> State size af tap. <br /> .��.y.......Tap to be inserted in the mnin. <br /> ........ � <br /> ...._� \Valer eloset 2 � � 5 tl— <br /> .....�.........Bath <br /> ..... .-��:-.Urinal <br /> ....—.....:Plnin faucet insi@c e"'��� w <br /> ..... . .....Side tenik «•osUcr ' <br /> ... <br /> ......_!�....liosc bib oulsido � ' . '� ;.,,. <br /> .....-:.-:.::.Hose bib for Luilding nurposes �^ ��� � <br /> . 1.....11ose bib inside , � �:.�.. ..� <br /> ......—.r...Bib for stuUle conlnining...................atall......_............ <br /> .........—..�'umber of persons in fnmily <br /> .........�...Num6cr of rooms in buildin� / . e <br /> The Premises nre to be used ne a...... I �• . " r'�-p� <br /> ...' ' •1 ...._.........._ . . <br /> Thc owner of tUe Prer.iises is�-:e--a„rc�-i,r�zz,,.,��. ��5„�[,��a.,n--,�t . :, s i + „T�"` t¢,�;`� <br /> Theagent is............... ............ ........... .... .. .. .......... .................................._ .,. y, ...; "�-�.7tf : <br /> "'� - npplicntion, although signed, ahr.11 not be binding upan the City, until � �-a '`t��I�� <br /> � Lhe Superintendcnt of lhe �Vnter Department. ' � ' �7 <br /> �,{�� � <br /> Signed.........(i 1'...=..........'..-..."_[,.. j .Applicnnt , � �����. <br /> � tr <br /> � �i . `�� i <br /> �.:...�.��:...��...�102...... HY.. �/�.............................. ' �� '� . <br /> - ��. Superintendent ,t,�';, s' �-', �. � ,a <br /> r <br /> . � . •.0 .W='?�1., <br /> v:r�. <br /> 1"5i�9�:.��, �. <br />