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��5?r�3�� � _ . �_ ���_� ;-y�,�-_,; , <br /> \V.O.Porm.b—ISSo—g.P.Co.-6-2G-.1 � . <br /> City of Everett�Water Department <br /> APPLICATION FOR WATER <br /> All blanks must Ue filled in or crossed out <br /> Evsrett�...................,.! .��.�...�....... ... ...rj.�`'..............192:�� <br /> TO TfIE SUPEP.INTENDENT 0: THL�' R'ATGR DCP'AI2Ti�SENT: <br /> CITY OR I:VLI:�TT: <br /> I ]iereLy aPP�S' for the use of�vater in accm•dance witL tlre rules :md regu- <br /> Intions of the Z�'ater Department, Sor purposes and fixtm•es statecl bclo�v. <br /> During the time thnt any of the watcr mnins mny be taken up by renson <br /> of nny improvements aulUorized by the 'ity of �cerett, �n or of uny street or <br /> nlley in which they may lim•e been ]nid, thc City will not be required to furnish <br /> wnter eluring the jirogress af such improvements to any consumer '++hose sUPP�Y <br /> � m:iy thus Le cu6 off, or/bc/li,u/ble�yfor any dauu�ges for its fnilure �:u to do. <br /> Applicntion No.....19.1��7`��d���.......... <br /> Ulock................................ o�... .....� .. Add......_....._.___.............._... <br /> .......... <br /> / / <br /> No..........�/._.��... .�.. ..CGYt!(.l��....Street <br /> .............................................................._............_......._............._..............._._............................ <br /> Tl�e work to be execcted bY-...... _.._... .. _......._ ..........._. �--.........�i�'�/ �� . <br /> P• �J�i�e / t � y <br /> State ize of tn l <br /> ....��Tap to bc :r�nrCed in the main. � � <br /> n _� <br /> ................Wnter closet �•--• 6( „�. U• <br /> ................Bnch ��� .�:''�3 � ���� c�� <br /> ................Urinal . �� ���QY � " <br /> Plain faucet msidc �9�� <br /> __ :"" ' CITY OF EVEAEijiWbTER DEP'T <br /> ......Side walk waslier _// <br /> . Hose Uib ouLsido BY........�..............C.C, <br /> / . ................... <br /> ................I�osc Uib for building Purposes <br /> ................Hose bib insidc <br /> ................Bib for stable containing....................stull.................... <br /> ................R'umbcr uf persons in fumily <br /> ................NumUcr of rooms in building <br /> The premises are to be used ns a..._._._.........................._.__....................._............. <br /> T6e o�vner of the Premises is................................_................................................... <br /> Thengent is..................................................................................................................... <br /> This npPlication, althou�h signed, ,hall not be binding upon the City, until <br /> ❑ceePted by the Superintendent of the �yate�r/Department. <br /> SiRned.'.�............(/.1:--:.'-fr-.,_;.'.t.f...���........._......A�'cnnt � <br /> -.� - i'1.o.�.� B _...��/2�..�i'....��j.(:.:!/���/ <br /> Accepted.._��.... _........_. . p. <br /> .SuD94��flm <br /> v� <br />