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� <br />6 <br />Ls�•-r.._ ., �.`"�F-.t4� /-}�. _ i +-v.�+n�-cl /n-�.1"�l. <br />� .. D. Form �-IGOn-E.P.Ca.--G-2&21 <br />City of Everett��Uater Department <br />APPLICATION FOR WATER <br />All blanks muat Lc filled in or crasecd out <br />O <br />Evcrett. ................................./--... ..._.�'.. �....... ...........19�.� <br />PO TII� SUPERINTENDENT OF TIiI: NATER DEYARThSGNT: <br />CITY OF EVEI2GIT: <br />I hereby apply for the use u[ wnter in ucrordnnce �rith ihc rules and regu- <br />Intions of the Water Depurtment, for pmposes nnd fixttu•e; SIRCCtI YfCIOW. <br />During the time thet any of thc �vater meins may be tnken up by reason <br />of any improvements authorized by the City of Ecerett, in or ot any stccet or <br />nlley in which Ihey may have been laid, the City will not bc required to furnish <br />�vnter durin�; the progress of such imProvements to any consumer w'mse aupply <br />mny thus bc cut u''f, or be liable for any dameges for itc fnilure so 10 do. <br />Applic¢tion j ...........:.:...: �:... �........... <br />BlockNo........ ...Q...2..�.......�-.�.—.q�%......2ch ................Street �:.._:.:...._:::..r..._ <br />................._h.................. Lot.........�i"..�........_............ <br />� _ , . . Add...::,.�:..�..� . �_ �. <br />_ <br />...................................................Q................................ ............. - .. . <br />. ............... . . . . . . <br />The work to be executed by..........._..._.._...... . .. ._ _.....Pltmber <br />State aize of tnp. <br />.�1�-.......Tup to be inserted in the mnin. <br />.......�.......\S�ater closet <br />......1........Bath <br />................ Urinel <br />/7 , � S o—� <br />................Plnin faucet inside <br />................Side wnik n•asher <br />................Iio�e bib outnide <br />.._.........._Hose bib for building purposcs ; '� �� <br />................Hose bib inside � <br />..............Bib for stable contsining....................etall.................... <br />..�.......Number of persons in fnmily <br />�............Number of rooms in bvilding n• <br />The premises nre to be used as a._.. .._.h-�.k-�-xC,...Q...e.)..,L,[�_.C.���..........�...�.. <br />The owner of the premises is...�t/1A!.. ... �y / <br />.The ngent is ...................................._.........._._....�.................................. <br />. This npplication, elthaugh signed, chall not be binding upon the City, until <br />��r�- ted by the Superintendent of.�the Wnter Departmpnt. <br />. 4, / , <br />�.. Signed...���:�2.....:4.��C..G..t.....��....���4�.L� ........_..A plicnnt <br />/ <br />1/- 3D � - <br />....................ioz,� By.. ,... .. ............... <br />� e _ ent <br />i <br />