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_ � � 1, . '�I [ �� A-�i�/ <br /> I�NTJ �'35 .11l,y n W�`5/�I `Is �d �' <br /> _ / . <br /> W.f).1'ormL-iLOo—EP.Ca—ry�.pd � � <br /> City of Everett�Water Department <br /> APPLICATION FOR WATET�Z ' <br /> All blanks must bc filled in or crossed out , <br /> E��erMt...........L.�.��3....�...................._....19::...... � <br /> TO THE SUPliRINTliNDI'sNT OR TIiE R'ATF.R DT•.PARTTi�NT: � <br /> CITY OF �VEI:CTT: <br /> [ liereby npply for the u=c a[water in acrordnnce w'ilh Q�c rules nnd regi�- <br /> lations of lhe SVater llepnrtment, for putposes nnd fi:clures xtated bcloa•. <br /> During the lime thnt any of the watcr maina may be taken up Ly reason � <br /> of any improvements authorized by the Cily of G�-crett, in or ot nny sLrcet or <br /> .�Iley in a•hich they mny ha�•e bcen laid, the City will not bc required to furnish <br /> watcr during lhc progrc^+ of such improvcments to any consumcr whoae supplY <br /> mny thus 6e cut off, or bc ]inUle far any dnmagea for its fuilure so to do. <br /> Apptication No....�fl..��................. <br /> , ,JBlock......_......................././..� Lot.. ...��.j....._.._... Add.__......__.......__. .._....._.... <br /> No......�.p2..(J..7.....<C<... . . .... .... ...............Street <br /> .._._._......_.... ......................................................................................--............_................._.... <br /> The a•ork to be executed by._.._._......__............__.....................................Plumbcr <br /> State eize of tap. <br /> ..�]�(". Tap to Uc inserte�l in L6e mnin. <br /> ....�./.......Nnter closet <br /> ..f..........Bat6 <br /> ........".'�...Urin el <br /> ._.�........Plain fnucet Inside � . ��, �"-: . <br /> ..._s.:.:.....Side tcnik �enshee "�- � ` <br /> �' <br /> .._.L.........IIosc bib outsido ��–' � <br /> .......�'....Iiose bib for building purposes Q � <br /> .....-......._Aoae biU insidc �,S �— <br /> ...-.:.........Sib for stable contnining....................stall............... ,,, �j., � U � <br /> .'�Q <br /> ..�...........A'umber ot persons in family ��a� <br /> . .�(7........Numbcr of room� in building <br /> The premises nre to he used as n......_... ..... . .. �.. .. . n. <br /> "' owner of the premises is...�i. ..�__a�„(rt,LZ„!� <br /> gentis......................................_..............._........................._................................... <br /> �nplicntion, nithough eigned, nhnll not be binding uPon ihe City, until <br /> � tlie Superintendent of th/e�Nn:er Depnrtment <br /> Signed�..�.�.f�.'f.�......!//.i......../!S,!%..W..I��, ..Ap�icant <br /> // • �.�...� � <br /> � ..��...–.�.�.'C.:t�........1�J2...... IIy...f(�zl��Cq C __�.......... <br /> en ent <br />