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� <br /> � <br /> I <br /> `.sx.o� ,�_ r�77�� , �----��-q - • � ,: , , ; <br /> , <br /> 1V.1!Porm 1�-IL00—&P.Co.—g.g6-21 <br /> City of Everett�W�tei• Ue}}artment ��z <br /> APPLICATI�JN FOK tiUATER <br /> All tilarks must bc fiiled in or crosmd out � <br /> ����T_��,..............���1�........ �_y...._ .....���.7 <br /> TO TIIE SUPERINTEsDli\T OF THTS �F.1TER DEPART\fE:VT: <br /> CITY OI�' �vEP.liTT: <br /> I hereby xpply fo- the use of�rater in acccrdanre�vith Lhe rvles �ad regu- <br /> lations of t3c �i'nter Dc�artment, for purposes :md fiztums st.ated below•. <br /> Uuring thc timc lhat any of the wat.er m�ins may Uc taken up '�y rcason <br /> of nny improcements auqiorized 6y the City ot Ecere[t, in or of nnp etreet or <br /> nllcy in tchich thcy may ha��e been la�d, the City will not be required to furnish <br /> �rater during LUe progresa of such imp�ocementa to any conxumer whose eupply <br /> may thua Lc cut off, or 1'c li/n�blc for sny dumngca for its failure so to do. <br /> Applicetion No._.(�.��....2.��......-7�z�— <br /> IIlock.?..............:'_............._...�Lot.... . ..._ � . . Add....�.....___...._...___._... ..... <br /> No....CJ..c�..��..... .. ' .Street <br /> ..._......._..._._....................__..._..._......_.............................._........___..._..........._...._............ <br /> Tlic u•ork to be executed by..... _..�� . . . ..._..Plumber <br /> 7mw�: ���1 G <br /> State sie of tnp. U p j.3 f/�� <br /> / <br /> ...�.�—....Tnp to be inF�erted in the main. <br /> ......./......_�i'nler doset <br /> ......1.......Bath <br /> ...._-.....Urinni <br /> ......Z...Plain fnucet inside � � <br /> ........--....Sidc o�¢lk '.cashcr <br /> .........-.:.._Hose bib ouLaide <br /> -_-.....—...Iioae bib for building purposes <br /> , .� / .�:::I.�.;A, , <br /> .._.._-:....:Fiose biu inside ' . <br /> .._..._�....B:b for atuUle coutnining....................etall.................... <br /> ......... ...Numbcr of persons in fumily <br /> ......�....Nvmber of rooms in buildinq <br /> The prem;ses nre ta be used ns a./.. '.__...... .. ....... .... . . . . . <br /> The o�vner of the premiaes is....L�f.'..�...........�..�1��+-�c........... <br /> Theagent is...................................................................................................................... <br /> This npplicatian, allhocgh signed, ohall not bc binding upon LAe Citq, until <br /> accePted by the Superintend0ent of Lh { ater epn ment, <br /> Sign ed.�......rl._�..�...L�'"`^-^�.1........................APplicnnt <br /> Acrepted.....__......._............_._..1D2...... By..__............................_............._...................� <br /> Superintendent <br />� <br />