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I <br /> I <br /> 1 <br /> I <br /> . 6`A-u=yv-�.,-C n ' 'i <br /> • ' -�.-Y..�-�-�Y ��._ y v_���/3;�i <br /> W.D.Form S—I600—EP.Co.—G-26�2d � • � <br /> � City of Everett�Watei� Department <br /> . , <br /> APPLICATION FOR �TATER � <br /> All binnks must Uc filled in or crossed out �i <br /> �/� ! <br /> c���T�tc................................:.........................................is2,s <br /> TO TH� SUPERINTENDENT OF TIIP WATIsR DEPARTh1LA`T: � <br /> C1TY OR EV�12�TT: � <br /> I hereLy npply for the use of�cater in accordnnce t��ith tl�e rules and tegu- <br /> lntions of lhc \Vatcr Dcpartment, for pmposes und fir..ures stated bclow. <br /> During the Limc thnt nny of tle watcr mains mny Ue tnken up bY renson <br /> of nny improvements nuthorized by !hc Cih• of Ecerctt, in or ot nuy xtrcet or � <br /> allcy in which they mny have becn la�d, thc City will not be required to furnish <br /> ��•ater during the progress of such improvemenls to n�y consumer whose aupply <br /> _ <br /> m:�y thus hr <u6 off, or be IiaUle for r,ny dnmages for its f¢ilure so to do. <br /> Applicotion No......................{..�. � '� . <br /> ............ �, <br /> I 1 '.� <br /> IIlock................�...�n........._�]Lot...........�......................... Add...._'..:...`:`.:.`::......:......_..— <br /> No............�..5.�..(......!l?:-rC�.�.-�.-r:��.............Street <br /> .................................................. .......................... ..................................................................... <br /> Thc u�ork to be executed bY.................................__.....................................Plumber <br /> Stnte size of tap. <br /> .....�7.r....Tap to Ue inserted in Lhe mnin. <br /> .....1.........Natcr closet <br /> � ..Bnth � ' ' � S � ° . <br /> ... ......... � <br /> . - ..Urinnl �' -� � � <br /> .�- ..Plain faucet insidc � <br /> . � ..Side a•nik wnsher � <br /> ._��...Ilo�e bib outsidc �.�'..:,. <br /> �^ <br /> .....:.:........Iiosc bib for building purpuscs I • , <br /> .....-:....._Aose bib inside ' �..,.:,.,: <br /> ......c.::.....IIib for stable contnining....................stnll.................... �.,.- .. <br /> ...... �.....Nunibcr of persone in fnmity <br /> ......�.....Number of rooms in building /� , <br /> The Premises nre to bc used ns n.........1..1�a�.cQ.R..�:�.-.s�.jJ..................... <br /> —�%—�-- <br /> The owner of the Premises is....SI�::c�.,,w.a—.c.1-a,.,`.�....�..a_.G��,.3�z,t <br /> Thcngent is...................................................................................................................... <br /> '- npplicnlion, ¢lthough signed, shnll not be binding upon tUe City, until <br /> �y the Superintendent af tkm \Vnter llepnttment. <br /> , �igned............. ..................................... .................. .. . ... .... ...Applicnnt <br /> i <br /> �_�2/...2.5.:...1�z...... By............ .. .... ,: ......................... <br /> I �;�- uperintendent � <br />