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Ztl+._ p li/.7 � C-.:�.lR�t.i-c� �l.: �- .- � j I:• �-�y <br />�7—. � •. . <br />w, n. ro.� �—�;,uo—r,.r.co.—sss .i <br />City of Everett�Water Department <br />APPLICATION FOR WATER <br />All blunks must Le filled in or croeaed out <br />� �b n <br />� Ecerett........._ ........................r.. ...........................1921�... <br />YO THE SUPERINTLNDENT OF T[i� NATER DEPA1:T11SENT: <br />CITY' OF EVERETT: <br />I hereby npply for the use ot �rater in nccardance a�ith the rules nnd regu- <br />Intions of the W¢ter Deparlment, for pm�poses nr.d fixrm•es stnted below. <br />During the time thnt any of the water mnins mny be token up by rcnson <br />of nny improvementa evthorized by the City of E�•crett, in or of any street ar <br />nlley in which they mny ha�•e been laid, the City will not bc re�uired to furnish <br />wnter during the progress of such imnrovements to nny consumer whose supply <br />mr.y thus bc cut o[f, or ebe liublc fur nny dmm�ges fo�r 7its fuilure so to do. <br />Application No........A.�...�-..�...�..........� % S / �'.��'" <br />Bloek....�+ .....................�...l._ _Lot...._p�o_�:.-�_o._. �1d"�~'-"�'"."_�_.'"_"."9' �_"'"�n� <br />Nu........�g.�...5.........1.T�W .......................Street ' '�1 r <br />(! <br />The work to be executed by......__....__..__ ........................ _...................P1mnUer <br />S te size of tnp. <br />� � p0 <br />Tap to be inscrted in the main. �� <br />�. ........ 1 <br />.......r.......Water closet � � � <br />....1..........Bath �', _. <br />... ......Urinal ,��� <br />...... <br />...�:......Plnin fnucet insidc <br />................Side walk washer � <br />_L.-.......Hose bib outsidc <br />.... .....Hose bib for building pu:poses � . <br />..... ....Hcse bib insidc �� <br />................Bib for atuble conlaining....................stall.................... <br />................Number ot persons in fnmily ' <br />..�.....Number of rooma in buildin , <br />The premises are to be ased ns a..... .. <br />�"�.. ...................... <br />The owner of the premises is.�L3,�,.ycL(.K.t.,,µ ..............5,�.t.q�_. <br />Thcagent ie .........................................................._��............. <br />.......................................... <br />Thie applicntion, elthough siqnr•I, shall not be binding upon the City, nntil <br />accepted by the Spperinte en f t e Water Depnt ent. <br />Signed!.6%�........i..C.t.e.r... .......... ......................A licant <br />Accepted....r.:IR-..-.-...........192..�.% B9. .. . . <br />� . ........ . . . . . . ..... <br />/ Superintendea <br />