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cn%�' � . � . . ' _ r- .,� .y/Z' . - _ , .ir <br /> W. D. Form{ I500 J-I-17 C.P. ' .. <br /> CITV OF CVERETT==Water Department <br /> Application for Water <br /> AII Llanks must be GIIf d in or crosscd out� <br /> Gcrrctt.....'�V_`.".-[�_�'�jp_______.-1�__ <br /> TO THE SUPERINTENllICNT OF TIIE NATBR DGPARTMBNT, <br /> Ci7'Y OP E`IERETT: <br /> i h�r�i�� ,nn�v f��*��,^use o(water in accurdance xith the rules and regula� <br /> tiuns o(The N'ater Departm•a[,for purposes and fixtures stated bcluw. <br /> DurinR�����imr that anp ot the watrr mains may be taken up by reason of <br /> any imprnvements authurizcd b��the t.u> o( Everett,in or o( any strcM or aliry in <br /> w�hich they may hr,vr, been I�iid, the City will nnt be requitcd in (urnish water during <br /> the prn�;ress a(such iinprm•ements U�any cnnumer whose supply may ihus Uc cu[ <br /> nff,or bc Iiablc fnr an�y Jdam�ges for its faiWrc ;o to du. <br /> �� Applicatif'q No../_��v <br /> _"_'_.'._. <br /> isi��k �T�S — �.�,i..�/_���_-_.naa _ <br /> --. — -- - <br /> No.---. yy7�Y-Qi-t�,..�r� ----_strecc <br /> � - - <br /> 'I'he work tn bc executed Uy................ ........... Plumber <br /> , /Sltatc�Si).c u(tap. % •,� � 'Y y <br /> vo <br /> �/Y-..?�'ap lo bc iusrrted in thc aiain. I�� i (9� <br /> / <br /> _.___I'__15'alcr dusct <br /> .._._ 7._.13a1h <br /> ._. _ _ .Urinal 4 <br /> . . _..-___Plain faucet insidc r 1��` . <br /> ._._____Side walk u�ashcr -, ���� �1 1�� . <br /> ._._....i1u=_e bib outsidc , �' � � � � <br /> c <br /> .._"__.Hosc bib for buildinF purpascs . �' . <br /> ._ __ __.Hosc bib inside .�. (._ J . <br /> --.__' "_Hib(orstablecontaining.._..._.._._stall."__...-�. <br /> ._ Iiumbcr u(persans in f�mily . <br /> _._"j\mnber nf mums in building <br /> Theprmnisesarclobeusedasa_._'.___.________".______.______" """ <br /> �I:e owner o(lhe premisrs is .._"'___""_._..__..__._.______.__". . __- <br /> l�heaRcntis. ________ <br /> ..__ ___'__.__""' ___._.__'_______________________ <br /> 7'his ;ipplicatinn,although siRned, shall nut bc binding upon thc C�ly, until ac� <br /> cepted by The Suprrintendent r the \Vnter UepnruneiL -.. <br /> Si�<ncd �J._� / __.AppLcant <br /> Acccpted.f�.�/....�/ 3y_.L '/ . / <br /> ' __Sui.rlrlenaeni'__ <br />