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<br /> � W.D.Form 1-160D—EC.Co.-6-28�R� 4
<br /> City of Everett�Water Depai�tment
<br /> APFLICATION FOR �TATER
<br /> All binnlcs must be fil� i�i or crossed out � � - ,
<br /> lverett....................._.(../^...��..._-b......................_.....1924._. , ����.+
<br /> TO TAE SUPERINTENDENT OR TIIC R'ATF.R DEPART➢f�NP: � � �:�i�
<br /> C1TY QF �VEP.r•,TT: � �
<br /> I hereby npP1Y for the use of water in nccordnnce with the rules and regu- �
<br /> 1¢tions of the Nater Dcpertment, (or pm�poses and tixtures stnted below. �
<br /> During O�e timc that nny of lhe �rnter mnins mny be tnken up by tcason - '
<br /> of x�y improvements nuthorized by thc Citp of Gvcrett, in or of nny atreet or - � �
<br /> nllcy in a•hich thcy may hnve bcen loid, the City « 1 not Le required lo fnrnixh
<br /> �vnter during tha proqress of such improvements to eny conaumer whoae eupply
<br /> muy thus be cut otf, or be linLle`'fnr miy damn�es for ifs foilore ao to do.
<br /> Application No...........a�. � E.. �
<br /> . ... ............ —�� �
<br /> ➢lncl:.......................�p......_...._ Lot....�:._�................._... Add.�..�<:<'. .t..:.,'!.�.:..:.i�.. ;
<br /> No...�.wSe�.-�....��_ _ ...�....Q....�..._"��_-.-.�. . .---.................Strcet i �
<br /> _ 1-.. . .
<br /> .................................................................................._......�......._..........._ _.........................._.....
<br /> The work to be executed by................�cDrr.e�r�, ....__.............Plumber
<br /> State eize of tnp. �
<br /> � ' '�...........Tap to be inserted in the mnin. N1J,�..
<br /> � ...Wnter closet
<br /> ............. •
<br /> ..._�.........Bnch � ., ,� .. J �
<br /> ��— `� s o —, �
<br /> ._............Urinel \{- ' I
<br /> ................Plnin fnucet inside /
<br /> ................Side walk washer 1i/m ; � S C� 'y
<br /> .Ilose bib oulsido ' ` � 5 � ; ,\
<br /> .__....._.. � , -' ,
<br /> Hosc bIb for huilding purtioees � ���� � " ; � � �
<br /> ............... I .., �, �, , �
<br /> ................Hose bib inside � '�i „ „ .
<br /> � :��� I�� �• ���� '�-•"
<br /> ................IIib fot sta6le containinBf:i�r1`�i;t:..Y,�tAII.Y..tll';tfER"D:;='I.
<br /> ...............Number of persons in fumily
<br /> �.. ..................�. . .................._..... �
<br /> ................Numbcr of rooms in building ' ' �
<br /> The premises nre to Uo uacd ns n...._. _ ..... �.._ . .......--'--�!-c�4.f>..q...�...........
<br /> Thc mcner of thc premises is........ . . ............t'GK:�-4�f"._....... �
<br /> .. ....__...... .
<br /> Thengent is............................................ �......
<br /> ....................................................................
<br /> This npplication, nithouqh siZmed, sliall not be binding upon the Ciry, until
<br /> accepted by the Superint ent of lhe �9n/ter�Depnrtment.
<br /> Signed.......... ............. ._ac......�.f.:..................... ..................... Appli t
<br /> Accepted..,.�.c..2�..........�/� By.. .... ^.
<br /> ..... . . ........ . .................
<br /> � rintendent
<br /> �° s,;,�y �' , ,
<br /> '' a . r f�.�;,;. x� a r s,�.�� �.�:^.r�S.:
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