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�/r/,U � —� ••_-<c, c � .. . y ✓— f"'-��/"��. <br /> N'. D. Form t I500 ]-0-V C.P. • • <br /> CITY OF EVERETTe=Water Department <br /> Ap�plication for W ter <br /> All blanks must be filled in crosscJ� <br /> ��ao_� � <br /> Everett. '____ . "'--"_--7 <br /> --- -- <br /> ..- -"---""--_ <br /> TO TI1E SUP3RIN7'ENUEN7'OF TIIE WATER UtiPARTMENT, <br /> CITl' OF E`/ERETT: <br /> 1 hrreby apply toi the use u(water in :�ccordance with the rules and reguln- <br /> tions ot'Che �Vater U�partm�_nt, for purposes :md fixtures s[ated below. <br /> Dm'ing the time thnl any o(th^wa[cr mains may be takcn up by reason��f <br /> any improvemcnts authorized br the City o(tiverett,in nr of any slreet or allep in <br /> which they nm}' have been laid. the City will not be requireJ to furnich waler durinF <br /> the pmgress of such improvements tn any consumer whase supply may�hus be cw <br /> ot(,or be liable for nny da/mages ofor ils failure so ro du. <br /> APplirnliunNo."7�?�0-""'_ • . <br /> 111ock .--�-''L----'- ----Lot��-.3---- -..._.Add.--'--.'. '-'-------- <br /> Nn.'_e�+..�` ��3c — �'w���i'�'"_""'_'__Slreet <br /> � 3 �-I <br /> ---- -- --- -- --- --------- - ---.,.--------- ------- ---- ------ <br /> 'Phe �vorkmbecsecutedby..___'_____"_' . ... -___'____---" Plumber <br /> Stalc eize uf tap. <br /> .._y�vT�p to be inscrted in the main. � /��= <br /> ___'f___W ntcr doset <br /> """�_.I3nth <br /> '__. _'_ .Urinal <br /> .___.____Plnin faucet insidc <br /> .___._____Side walk wasLcr <br /> '____.._Hose bib oulside <br /> ____'_-._.}losc bib for Luilding purposes <br /> ""___'__Hose bib inside � <br /> """__"l3ibforstablecontnining_________.st:dl-'..."' • . <br /> I ' __ �1 Number ot persons in (nmily � � <br /> � .___'C__.Number ot ronms in building <br /> I . <br /> ' Thepremisesaretobcusedasa___.____._____."'_"" "______" """ <br /> 'he owner of tUe premises is __"_'_____"__."__..._..____.__'__"""'__'.. <br /> .p The.Rentis _"'___._ ___.'____"___' '__--_'.'__'___""..____"_""_ <br /> I This application,although signcJ,shall not bc binding upmi thc Ety, un � c- <br /> I - by The Superinlenden[��f the Wnter Uepaflment. <br /> // O r <br /> ' Signcd __�C _ �c.-�- _ '_ '___'____Applicanl <br /> �.ecepicd. -__.______.� Ii�>..�/��4�_ . <br /> � �_--�-.-_�-.snrerlmendem _- <br /> � --�0 - �3 -��y <br /> ��. <br />