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s <br />R'.Il.FunnJ-Ispr-E.P�u.-i.-Jc_I ' , <br />City of Everettr-�3Jater Department <br />�PPLIC�I�TION FOR W1�TER <br />All blanks must be filled in or crossed out <br />,/ /i <br />T .l../ ...1933a <br />Everett ...................... .... ......................... _......... <br />TO 171li Sl'PERINTGNDENT OP TI3T: R'ATER UEPARTDfEN'P: <br />CITY OP EVliRLTT: <br />I L•creby npply fnr the u>e of w:�ter �n nccerdance'•vith the �vies nnd regu- <br />S¢tions of the Nater Department, for purposes and fis.ures stated bclo�c. <br />lluring lhe timc that any uf the «'���r mains may be tnken up by renson <br />of nn� improvemenls authoriced by the City a[ �cerett, in or of uny �treet ur <br />iilley in �cnich theY may hace been laid, the City will not be required to furnisli <br />�v:iter daring the n�'�gress of ;uch improvements to nny con�umer whose suPp1Y <br />m�y 1Lu� bc cut off, ur� �be liablc fur miy damuges for its fuilure su tu do. <br />Applicntion No......T...� G <br />Block. l" � y -La� -.._ �_J ........ Add..__._. ._... _......._........... <br />..... ........ . . ... �/ <br />No......__....�.f.�..�.6....._.../4�..�� ....Strcet � <br />_..__..._......._......._........_.... _......_ .............................._.._..... .._........._................... <br />.. .7hc ��'ork ta Ue executed b,�.. .. . . .. . ._._ � ..__ .. ........�/....FlumUer <br />�t �tc size of tny. . ��w` �� � � �j <br />-.3/�-..Tap to Uc inscit d m the mnm. �' Qa � ��/. d- <br />— � D �_ /� <br />. __._.R'ntrr closet �?��' p� <br />....._.....---.Bnth ' <br />. _.... _.......Urinal <br />................Plnin far.cet insid., <br />..._._........Side tealk v;u:;hcr <br />.__._.........Hosc bib oatsidc . � - <br />...__._.......Iir,sc bia ior h¢�.Iding parposes "- <br />................Ilose Lib insidr. <br />........._....Eib for atablc cunlnining ...................st:dl..._...._....__. <br />................NumUec of pc;sons in family <br />...... ...NumLur of rcom� in Uuildm6 � <br />The premises nrc to tr. used as a. /�� J--.... ____ ...__... <br />The oa�ner oi the Pramises is� ..%(....:_ /�/�r.u.�.(i-�L/�.........._... <br />!'hc ngent '.s ............................... ............................ V ............................ <br />, 'CLfs npplication, nithough signed, shnli noi be binding upon the City, until <br />�,' ,�ted by thc �up�rinlrndcnt ot the �Cn r Department. <br />�'�., � Signed._ �. ._�.... .. '.... .�..�. Dc'."`•'.....<.� e/ ...""-�`.. APPlicant � <br />�:, ��: rted..:_�._',� ............... `�� BY.... . /y r/................_. <br />�����Y��fcrintendent �; <br />