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� <br />��.z.e G—in-s.o �r <br />tP. I),I'orm <--IWO—E.P.Co.—G�2G-ti <br />City of �verett�W�ter Depai�tmerrt <br />�.PPLICA i ION FOR WATEI� <br />elll blm�ks must bc filled in or crosseJ out <br />. 1 p <br />Everett� ...................._.._..... . ..:..... .. ......_._:�..._...1 D2_� <br />1'0 TFIL, SUPEI{INTE?QDliNT OI� TIIP•. R'KPI'R I EPA1.T➢SENT: � <br />CITY OP EV�RliTT: <br />I hereby :�pply fm• thi�. use of �vater in accordance with the rules nnJ regu- <br />lations of tt�e �Vuter Depnrtment, L:r pw�pums and fixturcc st,ited Ueloa�. <br />lluring the time thnt nny of 'hc �cater mains may be tnken uP ��Y rea«;n �' <br />of any improvemer.ts authorized b} t}.e City ot Evcrett, in or of m�y �Lrect or <br />nlley i� irhich they may hnae Ueen Iaid, the City `�•ill nut be requ;red tu fu�mish <br />�vnter during the p�'ugress ut such lnprocements to nny consumer wLuse suppiy <br />mny tlms bc cnL u[I, or by 1}''7�bl fnr any dau•,ages for its fiilure so to do. <br />Applicution No......_ _°....1...5....��.......... — 3 �7 �3 <br />Block.............._. �.� _._.. Lat.......�........__.........__....... Add..._....._ __._. .........�.. ... <br />� ���, ��- ���---���-----^^^ <br />No..._.__.... �...�.....___....�_.!"�""`�1/.Y......_........Street <br />� <br />.._. __ _.._...__.........._...... .__............_ ................_..__..............._......... ............_.._................... <br />ihe «�oik to bc executed by...._......_ J.._ __ _._._.... __ ._..__....._ _..._.PlumLer <br />. Lnte s��e of :np. <br />i n / ro0 <br />..�.........Tnp to Ue inscrted in thc mnin. �7 --- <br />_...L.........R'nier closet <br />._.I.........Bnth <br />. _......------U r in nl <br />..__..........Plnin fnucet ii�sidc <br />._ .............Side mnik �eushcr �), <br />i <br />................Ilose Lib ouLsidc <br />......._.......Iiose bib for building purposes <br />................Flosc biU insidc <br />................Bib for staLle contnining.........._._.....stall.....__........... <br />._...y..Num6cr of persor.s in f:mily . <br />...J......_..Number ot rooms in building ` <br />Tl�c premises cre to Ue used ns a ��„��–•--� 0.e.-���tA„„ <br />.. .. ...... <br />Thc owncr of the premiaes is...... `�.,_...� ...� ,� <br />�_ , <br />Theogent is .............................._...........__ _.............._...... <br />. .........._ ......................._...... <br />This npplicntion, nithovgh signed, .hall not 6u bin�ing upon the City, until <br />nccepted Uy lhe Superintendent of the Nnter Depnrtment. <br />Signed ......._.. ... ._�..a.�_ lJ�.Q .... licant <br />.����,�cea.. � (�. _ - i�z�' u3. .���ite... i-t/�i����' <br />/ _ . .. . ...... <br />up ' c <br />