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,`c��.cy 3-�i3!_f' . �v�..�,_ 1t-13-=.4�..,,. <br />W. D. Form 4—�ICJO—E.P.Ca—G-^a-2C <br />City of Everett�`'�ater Department <br />APPI,ICAT��JI� FUR WATER <br />All blanks must Ue filled in or croased out <br />li��cret t ...................�.'�.c... 5.�.....�..�.............._...19"� <br />TO TIIL�' SQPERINTLNf)BN'I' OF'fHE ��'ATGR DCPAI2T3fI�:NT: <br />CITY OP �VEIRCTT: <br />I hereby aPPiY for tne use n[ �o'ater in .iccordance �vith the rules and 7e8u- <br />lhtiuns of thc �9nter Dep;vtment, for pu�poses +md fixtures stnteQ Uelow. <br />Dcrin6 tl�e time that any of Lhe water mnins m:�p be taken up Ly 7cnson <br />of nny improvements autLocized bp the City of Everett. in ur of any street or <br />allry in which thec mny hace bcen laid, ihe City will not be reqnired to furnish <br />wnter during the PT�6ress of such impracements to uny consumm� whose suPP�Y <br />inilu•e so to do. <br />'Blo�khus l�e cut �t, or Le lIaele for-�nY dumn es foAdd �. �. <br />S <br />�10/� 3 °q� <br />dpplicc mn No....../ 7....... .. ..1.. / <br />7 . t � � lt .. �. . <br />..... . . . . _ .. .. ...... _ _. <br />� .-_StiCet <br />P�O.......����.7. ""`" <br />. . ...... ..........�..:. . .................._ <br />--.........__.._ ........................................_...__.......... ..._...._................_. ._..........._ _..._.........._. <br />The work to be executed by.....__..._.G.:�Gf�f.�-__._s,...__..__.....P1umUcr <br />� �. q i,:. c_�_ <br />Stah; aize of tap. j�/ �� <br />_ i i <br />...d.�..��'."�...Tap tn Uc inserted in the mnin. <br />......�.......R'nter cleset <br />......�......r,nth �i . <br />......- ....... ti�: ir�al � . / . . <br />....._Z.._.Plain fr.ucet iusidc . �� <br />......_�._..Side n•vlk wnsher <br />_....�....._Huse Lib oulside <br />— <br />....._.........Hose biL for Uuilding Purpnses <br />..... ........2iase Uib insidc <br />.... ........_Bib for stable containin� ...................stnll....__.._...._. <br />_ ..::.........Number of persons in family <br />.��. .....Number n`. rooms in bu�lding � <br />The premises are to 6e used �❑ 7.`�- ._ ___ ._ ... <br />The owner of the premises ��yw.�=<. .���CC...:� 7.��.-. ._..... <br />Theagent is ............................��__._....._........._._._...._....................._..................._... <br />This npplicntion, nithough signed, r.linll not he binding upon the City, until <br />� � ��n+ed Uy the Supm�inten�nt,p[ the �Vnte.�Partme� <br />r r- ii <br />signed� ..............✓_c�c.�iti v A�cn� <br />.. ./.. ... .. ............... <br />.... ..... . <br />� yi � <br />,,�!,�-..�..�..-......1t�.1� BY....��1�.�.G/—�:,.� ,�-a'....... / <br />� ( S�y.;�[tl2rfident / <br />l <br />� <br />