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���7�Nr3a�j � �._.,-., l'/� 7,i✓_n,. i <br />.i <br />\V. D. Form i—�L00�-E.I'.Co.-G-2G-Sd � <br />City of Everett--�Water Depai�tmcn� <br />APPLICATION FOR WATER <br />All blanl:s must be filled in or crossed cut <br />Everett .............................. .. � <br />7 <br />y . ........ ....... ..._...�:,�-�.. <br />TO TH� SUPERINTENDEIVT OP TA��. �i�AT�R DEP.11,TP,IENT: <br />CITY OR �V�I2T�:TT: <br />I hereby apply for the use of �vatcr in :tccorAance tvith the �vles nnd iegu- <br />lations of the R�nter Department, for purpoecs nnd fistures stnCed below. <br />During the time thnt any of the wnter mnins mn3� Le tnken up Ly reasan <br />of nnp improvements aut}�orixed by the City nf '.�7rrrtt, in or of uny strcch ur <br />allcy in which they mny hnve bcen laid, thc City will •_ •C be mquired to furnish <br />water durin� the ptrogress of such improvements to i�: consumer whose euPP�Y <br />mr.y thus Ul�yyOff, or Uc liable tor any damages fe �.ts fnilure so to do, <br />Applicfitmn vo..........� � �'/ /� <br />.................. . <br />sio�k ......... ............................ Loc.'�..zr...._....._......_.... :.�a.... <br />_ ................... ._....._.... <br />No.....�� �,�..�.. ........_ .. .:..............._........._ ...3`.rc�t <br />Tlie work to be executed by.. ... _._.... <br />�ta e size of tap. <br />_��--..1'np to be inserted in the mnin. <br />....�.........R'utcr closet <br />..�...........Bntl� <br />................ Urin al <br />.�.-..._..Plnin inuc^.t inside <br />..-�.-.._..Side �valk washer <br />r..............Hosc bib outside <br />. _.____ .............._.................. <br />?...... ._. .._._... _...... Yi�mnbnr <br />� J" <br />�. J ` / �, <br />%�I� <br />......--..-- _Hose biU for building purpo�es <br />.-�-_-'..fIose Lib inside � <br />.............-..Bib ior stablc contnining....................stall ....�. <br />............ <br />-....5.....Numbcr of persons in family � <br />................Num6er of rooms in bvilding <br />The prnmises are to be used ns n..._ .. <br />/..............__. <br />� . ....... . ...................... <br />Thc oamcr of the premises is .............._I...�: C� <br />. _ . ..... .........__....._... ....... <br />. . . . ....... <br />Tlie ngent is .......................... � <br />. ....................... ................... ........... <br />.......................... ......... <br />This npplication, nitilmugh signed, ,hall not be binding upon the City, until <br />-cepted by the Superin ender�y of k� � Nnter Depnrtment. <br />{�d � <br />Signcd........../.\.J ..................Y............................__............_....Applicant I <br />�ceur'.ed....._ ............................._392...... B <br />' ��• �� . ... ...................:.......... �ri...e...�..... <br />!C/�Ls,� Jq�`z,y�ry'.ent <br />�! /G^o <br />