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_ t.���! if-w-r.� . ��'t.�.t-�.� 11� -�� - 'Tn.. <br />�i7 � <br />{S. D. Form d--1L00—E.P.Co.-6-26�21 <br />City of Everett�W�te�� Department <br />APPLICATIC�N FOR W AT�R <br />All 66mks must Lc filled in or crossed out <br />Everett. ................................._..��/�.................19 ��v.�... <br />TO TIIE 5UP�RINTENU�NT OR THP ��'ATlit DEPAI2Tl'.GrT: <br />C1TY OP EVCRPTT: <br />I hereby apply for the use of water in accm�dance with thc rules and regu- <br />lations uf the Nater Department, for pm�poses ar.d fisturv, slnted helo�c. <br />Dm•ing the time that any of the water mnins may 1 e tnken up Uy renson <br />of nny improvements uuthorized by tfie Citp of Ecerett, in or nf uny atreet or <br />nlley in �rhich they mny haee bcen lnid, Qhe City will not be required to furnish <br />rvater during the progress of such im�rovements to any w��sumer whose suPP�Y <br />mny thua bc cut off, or be Iiab1`G �for any damnges to: its failure so to do. <br />Applic�tion QNo.......... g_.��.....T...7..:.. <br />Blnck...................A.................. Lot._...:........................�...... Add.............._...._......._........... <br />ATo....../�...�r�....� r?......-....._. __ .. ' . ...:................Street <br />The wm�k to be executed by..._...__..._....... .._......_._...._ ...........................PlumUer <br />t s�ze of tap. <br />�_��._Tap to be inscr.ed in die main. �`�j <br />....I..........ii'ater claset 'r �( � <br />..../...........Bach �oF <br />................Urinxl <br />.. �..�......Ptnin fuucet inside <br />.._—.::..Side walk �vnsher � ' <br />..�.....Ho�e bib outside � <br />.......—.-...FIose bib for buili+ii�b purposes � ) <br />...—.--Tiasc bib inside / <br />....—:::::Bib for stuble rontnining......._..........stall..........._....... <br />.............: A'umber of persons in fnmily <br />.%f .........Numbcr oY rooms in building ' <br />The premises are to be used as a....... ._._.._........' .. .... �'�--� <br />. ._ .............. .............. <br />"" owner of the premises is.......�. ... ... <br />. ...... ...................�..............._.......... <br />"�•e e6rnt is ................ <br />................................................................ ................................... <br />appLcation, ¢1tFough signed, �hall noC be binding upon the City, until <br />a by thn Superintendent of the Nnter Depart nt. <br />Signed.<��......f/.."..�.-.f/.... ........... ' ...............:]Applicant <br />. .......... <br />epted. ..�l.....,,Gi...- ..............192...�.— ..By....F�„�.:,�, `. . ..... .. ... ..... <br />�TfSC�; permtendent <br />