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� <br />',` <br />� <br /> i <br /> .:,�c.a.,�.�, ��-q- �-� t F K • �.,�;rn.�!., s_ �a-y� rrn� <br /> o , . <br /> . lP.D.Form 4—IG00—F..P.f.o.-6-2G-26 <br /> City of Everett�--�Water Department <br /> APPL�CATION FOR WATER <br /> All binnks nmst Uc filled in or crossed out <br /> �verclt�.......................................�7��............._...19?...1. <br /> TO TII� SUP�RINTENDENT OF THG NATP•,R DliPARTilILNT: <br /> CITY OP E\'EIiETT: <br /> I hereby npply for the use uf�cater in accardnnce �vilh thc rules and regu- <br /> lations of the \Vnter Depnrtment, for pm��ioses nnd Cistm�es stated beloa•. <br /> During the time thnt any of the �eatcr mnins rony be tuken up by renson <br /> ot nny ��u�irot�ements authorized Uy thc Cily of I'sccre[t, in or of nnv strect or <br /> � ulley in which Ihe>• may hnae bcen laid, the City will not be required to furnish <br /> �cnter during the p�rogress of such improvements to nny consumer �ehose suPP�Y <br /> m;iy thus 6c cut off, or�cI lintlblcp for :my dmnngrs for its fnilure so to do, <br /> � APPlicntion No.............b...R...D...............- 'I I5� . <br /> ,� - <br />� Block................_.........:............ Lot...._.._.............................. Add......................_..:......_..._-- <br />�. No...__�..��_.�..�......�.�?.'.-.-�`r��..,................S;reet <br /> m <br /> I __. ..........................................................ll.......... ......._ . . . ........ ............................ <br /> The work to be executed by........_........ ........ ._............. _................._.....Plumber <br /> ' Sl t r�ze of tnp. G <br />� ��}'.._Tnp to bc inscrted in thc mn � <br /> ...... ... r <br /> ' ....�..........\Pnter doset I 7 <br /> � a <br /> ................Bnth I <br />� ........... <br /> .....Urin�l � � <br /> ................Pinin fnucet inside .y-y� � <br />' � . � '� ...Side �enll: «•nshcr ' / / I <br /> ......._.......IIosc bib outside -�'� <br /> ;,�_�.,�� � - .�� .............._Hosc bib for Luilding purposes <br /> ,�:'•��'-. . . � ................Iiose bib inside <br /> :��: :� '-. . � . <br /> . . . ................Bib for stuLle confnining....................stall.................... <br />� .................ATumber of persons in fnmily <br /> � .NumLer o[ rooms in building � <br /> ............... , <br /> i Thc premises nre to be used ns u.......... . �'".......___................'.. _._............ <br /> I • <br /> Thc o«•ncr of thc preeiises is..........__ . . . . . .. .� . ....................... . <br /> . . . ........ <br /> ..... ..... ...... <br />� Thc ngent is..._........................... <br />� . ................................__......................... <br /> .._............ <br />� This npplication, nithough signed, shnli not bc binding upon the City, until <br /> nccePted by lhe Superintendent of the \Vnter Depnrtment. <br /> � F._:._�__.=:"r : ,...i:... A licnnt � <br /> Signed.................5<c.s:�....,................ . _�..... �- PP <br /> Accepled.............s-./9.........10Y� By..... � <br /> ......P........................ <br /> / Su erintendent <br />� <br />� <br /> �_ - <br />