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,_ . , - t' �i_ ..� .- - -- "'-���- - <br /> / <br /> W. G. Form 4 I500 S-I-19 C.r. <br /> CITY OF CVCRC�I'T==1Vater Departmei�; <br /> E'l.pplicatio� fo� �ater <br /> :111 blanks must be Gllcd in or crossed nut <br /> — _ �y/ <br /> Everet[,_.._________________/- _ �_�-.-_-I9P���_ <br /> 'PO 'I'H@ SUPFRINI'ENUEN7'OF TFIE�VATER ll6PAItTn1GN7', <br /> CI7'Y OG IiYERGTT: <br /> 1 hereb)'apply (or ihe use of wnter in accurdanee with tie rules and regula- <br /> tiu;s a('fhe Nncer Uepxrtm,-nt, (or purpnses and fistures slated belmv. <br /> DurinG the timc that ana o( the wa[cr mains ma.�Ue takca up bY reason of <br /> anc impruvemen[s :mthnrize<I by the City o( Everet[. in or nf any s'rcet ur alley in <br /> which Ihey m�5' have been laid. tls Cily will not be rcquired to (urnish water durin� <br /> [he proqress o(sueh imprnvzments [o any consumer v:hose supply may thos be cut <br /> u(f. ur be liable for any dnmages (or its Cailure su lo do. � <br /> APPI iCnlion Nu.�'�I� l.�"_'__'_' <br /> Rlock __'.1^�K_� � Lot___/t__'�'r� Zd Add.__"- <br /> ..__._____._ <br /> V u.J�-.��.r__� ,\--t�`_^�S<?��r.�.''___'.$Vect <br /> „ ."""'______'_."",'_ ' ""'__"_""'_"'"'/"r___'.__" ""__""_"_"_'_"'_'_" . <br /> 'fhewudctob�eaecutedbY...___.___'LLL/<'i__________________ Plumber <br /> S:ate s'ee uf tap. <br /> O <br /> i• <br /> ��`�_Tap [a be inserted in the main. � <br /> _(___�__._1Vaterduset �i, /�e� <br /> _�___13ath ^'Z . <br /> _. . .�� -Urinal <br /> . .__h._.Plain taucet inside <br /> . ..Y_�___Sidc walk washcr � <br /> . ___:,�_Hose bi6 oatsic • i <br /> __ '!_'Hasc bib for uilding purpuscs <br /> _ _X___liosc bib insi e,'� <br /> � ___._.___Ilib(orslabi: ontaining..____�____stall....-.-__. <br /> ._. '_Yumue-of persnns in family . <br /> ._L'�_.Number of rooms in building � <br /> ___ <br /> 'Phenremisesare[obeusedasa_.__��-�'-at-_�_._... �.__..__ ..___. <br /> __/ <br /> '!'h�• u�vm�r of the premises is�-�Qlt_�.�.f,.._�._ 9�G�y��-h�7u1 . ` <br /> 'I�hc agen[ iS ."_"'___'__ _"'_'___'_"__ "_"'__ <br /> 'I'his applicalion. althuugh signed. shall no[be binding upnn Ihe City, un[il ao <br /> ,rptcd hy The Superimendent o[thr VVn[Sa�,�Depar mep <br /> / �/ / <br /> Signed�:_''! -��/✓vcL!'_'.'� __ ._ �.'��_APPlicant <br /> AcccNcd.�..��'''�/ f3y._ ' _. ___-__'_ . . <br /> __���n�ano:enc�ri-__ <br />