Laserfiche WebLink
, � <br /> �� �_.�, � :r. _ , , _{����k' �:� - , • .,. , <br /> lti.D.1'orm4—ILOU—E.P.Co.-6-:G2d ' <br /> City of Everett���%ater Department <br /> 11'�PPL�CATION FOR ��JA.T�R <br /> All Ulanlcs mnst be filled in or creseed out <br /> O <br /> Evcrett............./... ..!�............__....................._1J2.:S.�— <br /> TC ':"I:E SUP�P.1::1'::NDE\'i' OP TIIL R': 'CER DBPAI2T\[EICT: <br /> CITY OP EVLI2�TT: <br /> I hereby nnply� for tlic use ot �vater in nccord:mre �citn the rules nnd regu- <br /> Intions of th� Zi'nter Department, for pur�roses .md fistm�es stnfid belaw. <br /> Dm�ir.g thc time thut eny of thc watcr mains may Ue talcen up by rcason <br /> of nny imt�rocements nuthorizad Uy ihe City of Pacrett, in or of nny strcut or <br /> aRcy ir, which thep ��ay uaae bcen lnid, tUc City will noY be reqaired to furnisli <br /> �a:iter during tlie progress of sucli iiuprovmnents to nny consumer wl�ose suPP�Y <br /> ma;• thr Lc cat off, or Ue IinUle far :my damnges for its fnilure so lo do. <br /> � Q <br /> Applic.dion No..... ...J._:3....--'---........ <br /> .. ��: , J . Add/ <br /> Block.............._.....:,r '.-�'�:ot....._--J..... .... _..�.__..... ....__._.._.__ ..:.. <br /> /. . . ....._. ....... <br /> No.....�.J�U.s_.e. ...,r..�........... .... ..u.�r.-r—:r�/Street <br /> ... ._. ....._.. ...... ...... _ . . ...... .._... ......... ... ......... <br /> 1hi work to be exe^uted by. . .cr%�.PCi._ ._._._ tlmuber <br /> �t1ts size of tap. ' � . � <br /> ..i��._..Tap to Ue inser ed in the mnin. <br /> ._..�.........Wntcr clasct <br /> ._-.".::..._75u th <br /> ..._"':.....Urinal <br /> ..�:_.....nlain faucet iusidc <br /> ._.. .. ....c:an tvall: tt•nshcr <br /> ....../.........I-Iuse bib ouCsidc <br /> .......�.'.....Ho�e bib for buitdir� pm�poses <br /> .....::.:.�._Iiose biU insidu <br /> .....:.�.....Bib For atable cu�,:ainin�........_........stali... ................ <br /> ..._�....Number of persons in family <br /> '� Number of rooms in buildm <br /> � .-...... <br /> Thc Premises are to Ue used ns a .. .. �-. � _._. <br /> Tl�e o�vner of the prc��iises 15...� . . . ..�LL c :rc� � ...... <br /> _–— <br /> _ <br /> ��IR' .^.(�Cllt 15......................................__........................../......................................._... <br /> �plicatian, n$�ugh signed, h 1 not Ue Finding upon the City, until <br /> y� LLe Supcu6`.endent o:� at.er Depnrlment. <br /> 5igned..�Y1.(.(,.7��..._....�:NtGi�............_...�../.............Ap.�cnnt <br /> J a , <br /> _..............._. ..._..isz_ .. 8........ .... _............................_.._................:. <br /> � Suprrintendent <br />