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' riY�'v_t7-�o-C �+�-�-�-tY <br /> - 3_z(, -���''nl <br /> N' D.Form{—�G00—E.P.Co.-6•Y6-YI "'� ' " ' <br /> City of Everett�Water Department <br /> APPLICATION FOR WATER <br /> All LI¢nks muat be filled in crosaed out <br /> Everett........... ... ...�V�.��,,,1,...........................192...... <br /> I'0 THE SUPERiNTENDENT OF THE N'ATER DEPARTMENT: <br /> CITY OF EVERCTT: <br /> I heieby cpply for the use of water in sceord¢nce with the rules and regu- <br /> lations of the Water Department, for purpusea nnd fixturea atnted below. <br /> During the time thr�t any of the �vater mnins may bc tnken up by ieason <br /> of eny improvements authorized by the City of Everett, in or ot any atreet or <br /> alley in whfeh they mny hnve heen 'eid, che City will not Fc required to furnieh <br /> n•uter during tAe pmgress of xuch improvements to xn}� co:isumer whoue supply <br /> may thue be cut oft, or be linble for am���nages for ita fnil�rc ao to do. <br /> APP��cation No....�.-,�.`ji_ , �� <br /> / i,� �ti� <br /> Bloek...............S.L:................... Lot.....1....�..:�.�.�. Acd.............._......................... <br /> n o..,L°r�4.--�}v6{t�...�!�ce-c.-c...... :..s�rne� <br /> ................................................................................................_............................... <br /> The wark to be exewted by....._...._.................._.._........_...........................Plumber <br /> St/�e eize oi tep. 3 i'�� .1 ���{ <br /> cN- <br /> 3.............Ta� to be inserted in the main. �� � 7;. <br /> ................Water closet •w-.«�tit <br /> ................Bath �.Q .3 �� /lc� <br /> ................Urin.al �--"�� �d � <br /> ................Plain fuucet inside <br /> ................Sidc walk washer <br /> -���............Hose bib outside .^ � <br /> i . <br /> ................Hose bib for building purpases � /`"• <br /> ................Hoae bib inaide - <br /> : <br /> ................Bib for staUle containing....................etall............... <br /> .... <br /> ................?�umber of persons In famtly <br /> ��������.-......Number of rooms in building <br /> The premises sre to be vaed as a............................................................. <br /> ................... <br /> . The owner oF tbe premises is...................................... <br /> ................................... <br /> ............. <br /> eegent is......................................................................... <br /> ...................... <br /> ....................... <br /> Thie application, nithough signed, shnll not be binding upon the City, until <br /> •�ted by t6e Supr:intende t of the Watrr Department. <br /> Signed,l..�..... ..... ..!. ......L/5�...�R� <br /> 3�, � 2 ' APPlicant � <br /> . <br /> ... L <br /> ...... <br /> �te: .........:............' <br /> ............ ........ IIy... ... ............f.��. . <br /> .......................... <br /> � ' Perintendent <br />