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- - - - -- _ ---- .. <br /> ___ <br /> ���/7i,y . • �t� �z�_��-i� <br /> .orm 1--iGOJ—E.P.Co.—U2G-21 <br /> City of Everett�Water Department <br /> APPLICATION FOF WATER <br /> AlI binnks must be filled in or crossed out <br /> Evcrett...................L.::f-��l.�l�l:...-��.....1'J2..��-..r <br /> TO THE SUPERINTENDGNT OF THE NATEIi DGPARTMGNT: <br /> CITY OP EVLR�TT; <br /> a hereby npPly for tlie use of�vater in nccordmice with the rules nnd regu- <br /> 1¢tions o[ thc Nntcr Depnrtment, for pm�poses imd fistures stnted bclow. <br /> During the time thnt any o[ thc ���nt^r mnins may Ue lnkcn up by rensun <br /> of nny improvements authorized by lhe City of Evcrett, in or of any strect nr <br /> ulley in which thcy may Imve been Inid, [he City will not bc required to furnish <br /> wnter dnring lhe progress uf auch iropro�•ements to nny'cunsumer w•hose supplY <br /> muy thus be cut off, or Le liable fo/yr any dmm�ges for its fnilure su to do. <br /> nppt;ention xo..... .�.1....�.i'_?. �' (C�9`� <br /> Block........................................ L ...................................... Add........................................... <br /> No���..�.�...0.....� � :t�f.lr!"��Strect <br /> ..................................................................................................................................................... <br /> The work to be executed by..................................._......._..........................Plumber <br /> ��t syze of tnp. � �� �� ���� <br /> �...Tnp to Ue inserted in th �v. � <br /> .....-..._...wac�T ao5�o APR <br /> ....:..........nncl, CIiY OF EVERETJ 1��1 <br /> — � J�JITER DEP 7 <br /> ................Urinni Y........,......�,.. C/ . <br /> �- Plnin fnucet inside ��"""'•-••--_.. � <br /> ....._....._ � <br /> ................Sidc wnl'� tvnshcr � <br /> -..._�........Hose Uib oulside � ' <br /> ......'.�......FIosc bib for Luilling purposes <br /> .....-:.......I�ose bib inside <br /> ...:............Bib for stuble contnining....................stall................_.. <br /> ..._-........Number of pereons in fnmily <br /> ....:r�....Number of rooms in building �.(7 <br /> The premises nre to be used as n..........__�..L,t�,,,.,,_.__,..... <br /> �7 .. .....�.... <br /> Thr nvner of the premises is.,l.��..�/..%......�.Q,(/..��� <br /> � . <br /> Th, ngent is.....................................................11........................................................... <br /> This npplicntion, although signed, �lmll not be binding upon tho City, u il <br /> ur-•nled by the SuperyiuJtendent of.Jfhe Nater/De}�artment. <br /> Signed..L.�{...I(Y:S..�.�C..ED..._�i�/�(�............... plicuitt <br /> . ;...'7..:.....��....�...�....lB�� By........�//���... ..1�. •i � <br /> . Sup i , e� en�' <br /> s� / <br /> " .., ie e �aA...� <br /> "�i <br />