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, <br /> L�-.�C��� t������a �� '. _'-��1 'j ';�.- 'i.c- /�'L��� • <br /> lV.D.b'orm 4-1b00—E.P.Co.—g.pG�24 , <br /> City of Everett�Water Depa��tment <br /> APPLICATION FOR WATER <br /> All Llunks nmst be filled in or crossed out <br /> Everett.................._...................�J.....�..-.rl................10� . <br /> TO TI�IL SUPliRINTENDENT OR THE \t'ATER D�PARTniEA"P: <br /> CITY OF �V�RPTT: <br /> I Lm•eby nPP�y for the use of��^�ter in accard.mce witl� the rules and regu- <br /> latiovs ot the \Vater Department, for purposes �md fixlm�es stated bclow. <br /> Dm•ing t]ie time that zny of the water mains may be tnken uP �Y reason <br /> of an;; in�Provements authorized by the City of Eccrett, in or of any strec: or <br /> nlley in «�hicli rhey mny hnve ber�.i laid, the City �vill not be re,uired to furnish <br /> water during the pragress of such it[�provements to nny consumer whose suPP�Y <br /> m:iy thus be cut off, or Ue linble for ,my damuges for its fuilure so to do. <br /> Applicatinn xo.........../�.�-.i........._....... 7 f8( <br /> > > <br /> Block_...�..`.�'_�..�>..... Lot.._/cJ�..��.........�............. Add._.L�....�..f....�...c..-- <br /> No......�.��.�...p�---ES�yt��'-4.?:c�....._Street <br /> . . ... .. ........................................................�................. . ... <br /> ....�-The work to Ue exr.cuted by.................__._. ._................._..:......................Plumber <br /> atltc size oY tap. � <br /> i ,� <br /> _.,�-..........Tnp to be inserted in the mnin. \S <br /> __�_..._.......R'ntcr closet �' � <br /> ._L...........Batn �'Y . . ��. <br /> ................Urin al . <br /> ��........Plnin favicet insidc � .. -,-� � <br /> _ <br /> ... .......Side ���alk wnshcr . �.P � 1 \��.-�_, . . <br /> . . ., - ,,.:,�... <br /> L .,,', .:'t _:.. <br /> ................Hosc bib oulside ,.�,r.�.�. : ._.... <br /> �- Hose Uib for Uuilding nurposes " <br /> ................ ' _.�-�. <br /> ,,...—....FIose bib inside . - � � <br /> .....`....Bib for stable containing....................stall................i_ '�� . <br /> ...�:......Number of persons in fnmily <br /> .�........Number of romns in buildi r • <br /> The premises nre to be used ns a.. __..___.._..__..__....._...__............ ._................ <br /> 'Phe owner of the pre�nises i . ...._......_......._.......__ ._.... ......... .. .. ... <br /> Thengent is...................................................................................................................... <br /> Thic npplicntion, alt}�ough signed, shall not be binding npon the City, until <br /> nccePte. �ry the Saperint dcnt of the Mater Deparrnient. <br /> Signed...._�..J..._�'_.`.�.`.�..-'.'�!^/.. '� _...__................. . �icant / <br /> AccePted-.....�..:.r��...-._...134.cY BY..4,. .�r�/2...r�................ � <br /> � ~k/� endent E <br />