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r .� a— �/ s�—�C <br />-�.� �,�. ;� - �-.2-sa ,,�- <br />1V. D. Ibrm d—IG00—E.P.Co.—G-2G-24 � <br />City of Everett�Water Depai•tment <br />APPLICATION FOR WATER <br />All blanlcs must be.filled in or.crossed out <br />/� <br />Everett,. ............. ....................1 � <br />TO TIiE SUPERINT�NDliN'P OR TIIE R'�TPR ULP.�RTnfENT: <br />CITY OF EVERLTT: � <br />I 1�ereUy apply for the u=^_ ui �cnter in accm•unnce wic}: the c�ule � and regu- <br />lations ot the Nater Depnrtment, for purposes nn�3 fistures stated Uclow. <br />During the time thuC any of the water mnins may be taken up by reason <br />uf nny improvements authorized b; the City of Ecerett, in or of a.ny strect or <br />alley in whirh thcy mny have Uemi lnid, the City �c:ll not be mquireJ to furnish <br />water during the progress of such imprurements to nny ccnsumer wliose suPP�Y <br />m:�y thus bc cut off, or �be �liable �far :my danmges for its fnilure so to do. <br />Ap�lication Na........-F�-`�'..-�.:.....�I � % I 7 `f / � <br />IIlock........................................ Lot.....✓..��._........... Add..........._.__............_........... <br />No........�.3..3.�......l.. ... . ..._ _. .._ ......... ....Street <br />.... .......... ........................................................................ .................. . . . <br />Thc work to be executed by......_....._____. _..._ _._ ......................._...Plumber <br />Stat size of tnp. � �.-�1. <br />..��..�.�:I.�.Tnp to be inserted in the mnin. .�.. r�� �, :' � <br />....._—.....Nncer closet ` ' l ✓� <br />.._`._.....Buth <br />.....�.-....Urinal <br />..e..�.....Plain fauect insidc <br />.. Sidc walk �vnsher <br />Hase bib ouCside <br />!; <br />................Hosc b:b Tor building Purposes <br />................Sose Lib insidc <br />................Bib for staUle contnining....................stall.................... <br />�..-1`Tum6er of persons in Fnmily <br />........ <br />....�.......rumher of rooms in building ' <br />The Premises nre tn bc used as n .. . ._'_.. .._ .. <br />The o�vner of the �iremises is... .Z�....�y._7lr�-vt-m...... ..._ t�-I—�� <br />Thengent is ................................................................................._�............. <br />This aPP��cntion, although signed, shall nut be binding upon the City, until <br />nrecpted by the Superii�ndent of the Wntec.� epnr�ent. � <br />SiGned.....�.,v: .�Z.'.�.�/77.51..�:. � ..�.t..... . �%/;/i.9 �icnn <br />/ <br />� .c^_Pted...�. _..—.�l �... ��....lrt'J2...... BY��r�^y-�i�� � .., ' . <br />.......... <br />� dent / <br />( <br />