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�;f�i U.. l. /�. J J- � �I N/�� I� C� ' <br />�v. n. ro�.+--isoo—r.eco.—c-:o-za <br />City of Everettr�3�7ater Depaltment <br />,A.PI'LICATION FOR WATER <br />All Uli:nks n��st be filled in ur zco�sed out <br />_ � <br />� �" . ........................102. 'a <br />E� �rett ................................ ..�.. <br />TO TI3E SUPEPINTENDGNCITY OP �V I CTT;DtiPA12TIII]��NT: <br />I hereUy� npP�Y for the use uf tcater in accordvice'.vitti the rules and regu- <br />lationa of the \Fater Department, for purpuses .md Lixtum�: sta[ed Ueluw. <br />During th. lirc� thal. any of thc watc: m��ins maY l+c talcen uP �Y rcason <br />of nny imProvem mts authorized by :he CiLy oi F.ecrett, in or of nny street or <br />nlley in �rLi:h thcy may hnve been lmd, thc City will not hc required to furnish <br />may thus�be i�t Off,�or bc li�ble for�unyVdamtuges�forits�fniluro so to5do.uPP�Y <br />n <br />Application No.........n.. ..�..Q ............. <br />...Lot.... .3..� <br />l . ............__. Add........._......._..__ _..._ _.... <br />B1ock ..............Y?..�..._..y � � � � <br />xo......�.G•�t ��..�rn-�z,e�a..�..�..str��c <br />_ ... ................ ..............................._..._..... _...................._... _.. <br />Tim work to be executed bY_._......_ ........ _...._.. _..:..... <br />.- ._ :..:..::: ......... _....P1umUcr <br />, • <br />Sfnte size of tap. ' ' .(� , ,n • <br />� ' ' ., �>�' r <br />„[�a?:...�--..TaP to 'ie ins^_rtcd in the mam. � <br />�........1Vnler closet ,� �7�� <br />.....I..........Bath � Y <br />.. _--,-:..-....Urinnl <br />..._ Li..Plair faucet insidc <br />,.,.,,.—:.Sidc walk �casher <br />:..",._...Hasc Uib outside <br />'-- ' <br />.........._....Hos= Uib for Umlding P::rpoaes �% ) . <br />--- <br />... .._......'Tozo bib insidc <br />�--- stall .................... <br />.............._I3iU for stablc contair.ing.................... <br />...............Numbcr of perscns in fa�r.il;i - <br />._.�7...NumUer of rooma in Uuilding � <br />. ........_:� .. ............... <br />The premises ar� to be ueed as u_..._h--�.�-r� �-����� � <br />The owncr c! tne prec�ises is......_ .............__......_..............................._..............._... <br />Theagent is ..................................................................................................................... <br />This n�plicntion, ¢Ithoy�},h signed, sh>.11 rrt hc bindi�g uPon thc City, until <br />accepted by the SuPerintep{�ent of fl:e N.�ter C�P?i�cment. <br />� � l� , f 1 <br />. / 1/1".... ..�.. i.:��..�.`�.. ..... ....J..Ap icant <br />Si�n d...... .....�...... �.�..... . .. �,... <br />Accepted.....lY.... �.O_....19'L.i.� r:' �� . . .. / ................... .. <br />�� perintendent �., <br />