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,.���� <br /> � �-.N..n._«`���- �-�--�..�`��._ . �.-.,`l1Al� 6-�`'-�'�7- �O�� � <br /> ' • ' <br /> W.D.Form 1-11F00—E.P.Co.-6 2G-2� ' <br /> City of �Everett�Water Dep�rtment <br /> APPLICI�TION FOR WATER <br /> Ali bl:mks must Ue fillcd in or crossed out <br /> --� / i <br /> liverett...................`=l...�..�.........................................ID2...��. <br /> 7'0 TfIG SUPERINTIiNDi:NT OR TIIT's tY:\TRR DEPARTTSENT: <br /> CIT7 OF EVI'.I2liPT: <br /> 1 Lcrcby nppll' tor thc usc of u'alcc in uccord:mm�cith thc rules tmd mgu- <br /> intions oC qic \L'ntcr Depnrlment, for pw�poses nnd tisturca stated bcloe•. <br /> lluring tLc timc thnt nny ot thc x�atcr mnins mny Lc tnkcc up Ly renson <br /> ot nny imprucements nuthnrized by thc Cilp of 1:�•crett, in or ot nny ap•eet or <br /> nlli�y in �ehich thep map hm•e Ucen Inid, the City n•ill not be requirr.d ;u furnish <br /> �c:iter during LLe p�'�Rress oC sUrh improt•emenls to nn,r cunvum•�� '���'.�.;-�' supp�y <br /> m:�y thus 6c ruL utt, ur br liable tor nny dmm�ges fm its inila:�� �•� .�� �o. <br /> . Applicnlion No..�_.�il.. ..�.....� 3� . <br /> I3locic.....................'...7_.... .....p... L�ot�..�..........,.[.�.. ............... Add........... . ......_. ._. _............ <br /> \u.._..�Sd / ./C/!/....-c-.�2.,U-........Strect <br /> ._... ...... _.._.. <br /> .. . . .._..._. .. ..........._....................................................................._... ........__........._.............. <br /> Tiu work to bc exccuted bY............_.... .. .___.. .. .__.�p. ..._....PlmnLer <br /> st:rtc size o[ tap. �O ��/J'. �(,(�. C " � <br /> .���_Tnp ta be inscrted in the mnin. I � ,3 �Q <br /> ....._�.........\Ynter eluset <br /> .../1�......npc�i <br /> � <br /> .........".-..Urinol ' <br /> .....Z........Plnin Cnucet insidc ./ <br /> .....�t.....Side a•ntk �enshcr � <br /> .....f.........11osc bib uutside <br /> ........'........Iio=c bib fur b�ildiug Purposes <br /> ...�'.'..iIosc Uib iuside � <br /> ._...-�._.IIib for stnUlc conlnining....................stall.................... <br /> __..':........Kum6er of persons in fnmily <br /> ................\umbcr ot rooms in Uuilding <br /> � `p L <br /> • + \ The premises r.rc to bc used ns n__ .... ..._.-..../J.�.... ... <br /> . .. . <br /> �... <br /> "` The u�encr o[ the premises is............. _......_........_.__._....._..................... ............ <br /> Thcn6ent is............................._................__..__............................................................. <br /> Thia npplicntion, nithough si�ned, ahnll not be UinJing upon thc City, until <br /> nccepted by lhe Superint dent ,f the \YnC DW�prtment. <br /> s�F���a... %'... �/I�.�....�P. .... ....... ......... ..��Pu�ant / <br /> .. � .. f <br /> / � "' � <br /> a��•�, n� _ lo_.:/�:....-..._i�z.. .. nv... . l <br /> � � � �l/ . ._............................. <br /> � Superintendent <br />