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. �--..—.:S._t' i� ... _—.. .. . . <br /> W.D.Form�-9f.J4—E.P.Co.-426-Y{ <br /> City of Everett^�Wa�ei� Depai�t:ment <br /> ,T ;;ATION FOR WATER <br /> All Ulnnks maet be filled in or crossed out <br /> Evc:�ett.......................�/? >l ...102..0., <br /> ........................................ <br /> �UY�RINTGNllPNCIT] OF F.V�I2GTT DGPARTDSENT: <br /> I hereby appl;� tor the nee of o�ater in accordnnce�cith :he ivles nnd tcgu- <br /> lations of the 1i'ate� Department, for purPoses nnd fixtums statzd bclow. <br /> Uuring thc lime lhat any of the waler maina mny be lalcen uP Ly reneou <br /> oL nay im �roeemenLs nuthurized by Lhe Cilp o( Ecerelt, in or of nny streel nr <br /> alley iu n•�ich the�� may hnce been 1s��I, lhe City will not be reqcired to fm�iiisl� <br /> n•ater during ihe proqress uf Ruch improvemenls to any coneumer whose supplY <br /> mny thus bc cut off, or`bc(/1�I� for any d�nz�s�or ita failure so to do. <br /> APplicatinn No..._.0....0...__S?.........../_ � <br /> Block........._a_C...._�...........�_ JLot...._.._�..`�' .. Add.__._..... ........ ................... <br /> No...._�_�._�..�...../�—::.c�-�t.��...........Street <br /> ... . . ..._. _ ........ . ...... . . .. � .. _. <br /> ... .................. . <br /> The �cork to Le executed by... / �y ��� �......Plumber <br /> St� 812C OL ttlp. . !1 / � J{ � �� �� <br /> Tap to be inserted in the main. �`� � �• � ---� <br /> --.._�... r�il' Oi EV�d¢7� VA'Ic(( CJ"T <br /> ._.�........Watcr doset <br /> :. / <br /> ' ....................'.��.....-.. _._....._....r. <br /> ..._...........Bnch .. <br /> ........ .....Urinnl <br /> ..._�.....Plain faucet ineide <br /> ,_..._`.....Sidc WAIIC ti��usher <br /> ......�........liose 6ib outsidu . <br /> ,,..%'.......IIose bib for building Pi��'F�o=es <br /> ...._... ....Hosc biU inside <br /> ...... .......Bib for stnblc conlaining....................stall.................... <br /> _..�.....Number ot Pcrsons in family <br /> .... .... NumUcr of rooms in building <br /> �...._ � <br /> The premisea are to be used ¢a e... .............. ... .... �� ......-..yp <br /> The oa•ner of Lhe prernieca is..._...�i2.........(�-.u_.tltrLl..�...-........-. <br /> The ugent is....................._ __._........._................................................_.... <br /> .........._........... <br /> Thie npplicntion, allhough signcd, r,hnll not be binding vPon thc City, until <br /> nccepled by the Sup�/erinte �nt�of Nnter Departmenb. <br /> Signed."....1���/�..����.-�........ .. .. Applicent <br /> > /�'�� <br /> ... .......... <br /> Accepted......._�.' .�.�.....�7�.....-:102..� � BY..._G7 l!. . . ... ....erint-... ent... <br /> ( <br />