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C.�1`+Y t .� r � . _ <br /> _ . �/1'�-XL 1L...� . . <br /> W.I1.Form b�IM1oO—F P.Co.-6-Yt�YI • <br /> City of Everett�Water Depai�tment <br /> APPLICATION FOR WATER <br /> All tdnnka munt be tilled in or croased out <br /> Eem•ett�. ....._...__�i.��.G�.... .�..�.�..�........1D2.�.. <br /> TO TIIR SUI'ERINTF.NDI:NT OF TIIF. R'ATF.R UE tTTfENT: <br /> CITY OI' 6VTRIiTT: <br /> I hricbp npp13� tor the u9c nt wptrr in nrenrd;mce�vilh lhc rulrn nnd teg�- <br /> lalinnn o( tMe Watcr Depnrtment, tor purpn�es nnd (Ixturrs xlnted Lrinw, <br /> lluring lhe Hme that nny ot thc wnter mninn may be tnken up by rcnson <br /> o[ anl' impruvemenln authnrixeJ by thc City n� Rvrrctt, in or nf ony etrrel. nr <br /> nlley in which th�y mny hnvN t�cen Inid, the City will not be required to [urninh <br /> water durm; tLn pinR�r» c{ �r.ch Imprm�ementn to nny cnnxumer w•hnne eupply <br /> mny thua L�� . at nt[, o� F.r IiaL:� fnr nny dnnmgrs for ite fnllurn eo lo do, <br /> i � _ <br /> Arnlirntl��u Nu...._ _,� . ..�............ <br /> Block.................... � .. ... Add.. I.... , �. . <br /> ........._. .../�l.ot ._..............:_. .__ .. .__. . .. <br /> No.... a.3 � �_ _/l:_.G_..ri�.l.v�............8tttet <br /> __ ___. .._ _. _... ... . _.. ... . .._......... _ . .......... .... _..... <br /> The work to be executMl by_ . .. . . .... . .. . .__._ ..... mUer� <br /> �St,n/t�c�t:e �t tep. j' � %5 U <br /> �/�6..I�.Tep m be inscrteJ in the mnln. <br /> ,/. <br /> ....._.�......Nnter clnect <br /> .._....�......Qeth <br /> .........`.�......Urin al <br /> _...�.......Plxin fnucet inxide � <br /> ....... ......Sidc n�nik wnalicr L� <br /> .. f <br /> ....._�.......Hone bib oulsido / <br /> .__.:. ......Hose bib for buliding purposee <br /> _ _ .-::.....Aaxe bib Ineide <br /> .......::.......Hib for etable contnining........._....._..elall....__.... <br /> __ <br /> ._.. --..Number ot pereone in fnmily <br /> ..... <br /> .__.�'.�....._Num6cr of roome In Uuildfng <br /> Tho premieee ere lo be ueed ae e ) � T i c .� <br /> n / � �.,c,� <br /> The owner ot the renil�A. . /, . � �� <br /> The ngnnt fe......._ � <br /> ._.... ._. ............__.............._._. <br /> Thl• npplicnNon, ellho nigned, ahnll not be b nding upon the City, untll <br /> �ce-�ed Ly thc CuperintenJ�tho W�Pepnr �� �,[ <br /> SlgneJ.. . C �_ ....... ..C.� . .. . �p plfcent <br /> .,.. <br /> r I <br /> -d . „I._ .. ..'� . .]D^."... DY_. . ..l��.� .�. e/ � +;5 <br /> ...... .............. <br /> � _ Sypi�rintendent <br />