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't;ttt-e�� . lo-`I-2y [t.�r' r..�..�c...a..w rolr ��v_ ��,.'U <br /> tS.D.i'orm J—ILOJ—E.P.Co:-6-:G�2f ' <br /> ' City of Everett--�Water Depai�tment <br /> APPLICATION FOR WATER <br /> Atl bl�nks must Le filled in or crossed out <br /> /o � <br /> �vc rett.................................. .......................................192.� <br /> TO 1'FIli SUPEI2INTENULNT OR TIILR \FATSP. PGPART'dCNT: <br /> CITY OI' �VlI;ETT; <br /> 1 hereby npp;p fm• the uae ot �vatrr in necord;mee �cith lhe �vfes :md regu- <br /> Intions of the \Vntcr Department, for purpo�es imd fistures shited Lcluw. <br /> During the time thnt am� oL the wnter mains mny bc lnl:en up Ly ren�nn <br /> o[ nny improcements aulhorized by the City of Peerett, in or of nm� street ��r <br /> ullep in wiiich they m;�y hm�e bcen laid, thc City �vill not bc reqniredJto fm�ni�h <br /> wr.tcr durir.g the progmss of such improvements to nny consumcr whosc sup�+ly <br /> ��:��3' thus bc cut off, or 6c liuUlc for :my dumnges tor its fnilure so to do. <br /> Applicntion No......_�0� <br /> ......... .............. <br /> Bloct:..........�...'.�....._....... ....... Lot._....Z......._.................... Add..:..�'_..:.�..�. � <br /> . ........._ _.. .. <br /> No.....2._l..f�!{..�Q.��O-�-�-................8trcet ' <br /> _.. _ ............_........_..... _........__..............._..._.............................. ..........._.......__....... .... <br /> Thr work to be exeeuted 6y.____......_ `--� -----� <br /> _... . ____..............._............'.. ......Plumbcr <br /> Stntc size of tnp. , <br /> _., _ .. ...,,.'.:.. <br /> �/�..'...Tnp to be inscrted�in tlm main. � � ��- � - � � � �� <br /> -..........�...Nntcr closet � <br /> ........_�....Bn[h \l��/' <br /> ................Urinnl . <br /> ................Plnin fnucet inside <br /> .:...............Side tcnik wnshcr � <br /> ................Hosc bib oulside <br /> ................Iiase bib for building purposes 1� • <br /> ................Hoee bib insidc � <br /> ....._.........IIib for stablc cuntaining....................stnll.....:........ <br /> .... <br /> � ..............Nmubcr u[ persons in fnmily <br /> .......�-f:_Numbcr of rooms in building <br /> Theqe�emisee are to Ue used ns n.. . .. .. .__... <br /> ..... .. ................................... <br /> Tlin o�vncr af the premises is.... ._...-�".'�._��,{_,� <br /> . . . .............................. <br /> The �gent is................................. <br /> ..._...__....................._..........._..................................... <br /> '^ �pPlication, nithough signed, �hall not Uc hinding upon the City, until <br /> tlu Superintendent of thc Nnt�.IIepnrtme t. <br /> Signed.............._�.....�V...__.. .. �C.........Applicnn <br /> ... .. ...... <br /> _.. _. <br /> � �,�•• n /`�� ,� / <br /> :..... ....... ...... ...... <br /> �:�... .. ......... <br /> perintendent <br /> _+r - ' <br />