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i /C ( �"�..� <br /> � W.D.Form! <br /> ��„j. ' , CITY OF EVERETT-WATER DEPARTMENT <br /> ''��= =�'x � APPLICATION FOR WATER <br /> , � . . <br /> "'%�- °� '�' "�•'� ' � � pil blunks must be filled in or crossed oul <br /> . oq.�.. t".y � <br /> i . t � . �,.� . �. , _ / <br /> y L.."��� C^C <br /> F '/ <br /> .. �, . Evcrell� .__...._ .....��-..� Y ....._... ._ .__.. .....19. .-/ <br /> l� <br /> i �' I, <br /> '.t } , ` TO THE SUPERINTrNDENT OF THE WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> ���'�: ;r � � I hereby upply tor lhe use o[ wnter in accordance with the ndes und regu- <br /> ��:'-1 t' ��� �� � Inlians ot lhe Wuter Depnrtmenl, [or purposes nnd tixtures stated belaw. <br /> "e d�G��r�.y ;�itd , � During lhe time that nny o[ the watcr mnins may be tnken up by reason <br /> kf'g) �i� � � o[ nny improvements uulhorized by thc Cily of Everett, fn or of any atreet or <br /> �'�`T 4.:�- � nllcy in which they mny have been laid, thc City will nol be tequircd to furnish <br /> +�r�, 'L wnte� durinF thc progress ot such improvementa to uny consumer whose sup- <br /> ��`� �"�-� ��`:q��. . �, ply may thus be cut olt, or be ]lable tor nny domnges for ils tailure so lo do. <br /> °"� r. ?u,Y�t ..:"�' �� , , �i � <br /> � r �, �. . � � APPlicalion No.� �...� / <br /> v"�r . A,� � ;., ^ �.. . �.. iol __.... � ._ . .._. <br /> .� <br /> ��' <br />� ,�04' � . . � � . Block... . ... . . .. �___ ... ... .._._.. ...... <br /> � €x A . . ' ' � NO .. ... `� � 3 S� Ct..l,rU-rrL.A.�t,� ��if."«�Ilreet <br /> �5�., r v tr`' t�e � � . ............ .... <br /> ✓ <br /> �V�.�h7.'ih. '�.� .... . ...... . ... <br /> . .. ........ . , <br /> �H tr� ��p M .u.: . __ . ... .. Plumber <br /> t <br /> :?,�_.� � The work lo be exe:uled bY-. ....- -.... .......__. _..-. <br /> ,� �� , Slnlc size ot lep. GC' t'`'�' <br /> ._ �"�,�z,' ' � , <br /> . "t ', �A ; � . ._ ._..Tap lo be inserted in lhe maln. �/�{ )c<' <br /> Y � ,G : . . .....Waler closcl �y yG7 <br /> il �, ' . . � , � <br /> 1[ ... ... Bn�h , � <br /> � <br /> .. i� ,�f Urinal <br /> y^ <+ ` . . � . . ..Ylnln fnuccl insidc �� �. <br /> ��{��'c�` �:y � � /. <br /> q,,,�kr���; ' � � ... . .S��ie wnik washcr ����"�¢ _ � <br /> . � � /�/-:�.. .�c' , � i....� <br /> " �� xt <br /> � • ........... .Hosc bib oulside <br /> � ( � .Yi. <br /> }w `y,i �'°I' i,.,..,3 . .. ..........Hosc bib[or building PurPoses ---� <br /> .di '�:�!, � - . ...............Hosc bib Inside <br /> �: e �x� t <br /> . �µ�,�y.j 'a. , . . .�. - .....IIlbtorstnbleconlnining. .___.._...stnll ....... .. <br /> �1���5 " � � . .....Numbcr o! persons in tnmily <br />, �� a�' i-d� Q, �� ...._Numbcr ot rooms in buildmg <br /> .�' �t��ii �, .` . � The Premises nre lo he used as n. . _... ._. . . ...... _ _. ._. <br /> ".� ° � �� 7'hc owner ot lhe premisca is _ .. .. .. .. . . - - . <br /> s , � <br /> : �� . �, The aRent �a. ..._.........__ . . . .. . . ._. ..__ ...... .. . .. . . <br /> � '�� • . �. . � <br /> .._ .. - �� This npplic�t�on, nllhou�h sipned, �hnll not 6c bmding upon the City, until <br /> � nccepled by lhe Superinl enl nt th/e�R'nler Depmlment. <br /> �id. .�. �'.7.!d-S...C�5,1�t�C.l�7� �.. . _..._.APPlicant <br /> � " � �yJr � (Ll�sw .. _.,� <br /> Accepted.__.. .__. _._....1D....... I3Y.. ._....................... ..._........_ _..........___. <br /> � ���-� fiuperintendenl. <br />� <br />