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z�..✓✓ ��-iz-ar-n �-•�--�P s_� 6_ 3t_ Ir <br />W D. Form �-160P—EP.Co.-6-26-4� <br />City of Everett�-Water Department <br />APPLICATION FOR WATER <br />Al1 blanks must be filled in ur croased out <br />Everett,........... S��' � <br />..................... ........................................IYL...�. <br />TU THE SUPERINTENL�ENT OF THE R'ATER EPARTMEVT: <br />• CITY OF EVERETT: <br />� I hereby epply for the use of water in accord¢nce with the rules and tegu- <br />lutiona of the Water Department, for pmposes and fiztures afited belo�c. <br />During the time that any of the water mains m y be teken up b}• reason <br />of nny improvementa euthorized by the City of Evere.t, m or ot any a::eet or <br />alley in which they mcy have been leid, thc City will ��ot be required to furnish <br />water during the progrese of euch improvementa to any conaumer whoae eupplY <br />muy thus be cut aff, or be liable for any damages for ita feilurc eo to do. <br />Applicetion No.......Q� U g, -� 5 S% �,/ <br />..... ............. <br />. _ . 1 C (L _ t� . .. /Y_ : � i / -, �`i� <br />The work :o be executed by ...................... <br />Sta eize of tap. <br />..��...Tap to be inserted in the mnin. <br />i <br />......�........Nater closet <br />..... � ................................Plumber <br />c ea <br />� �� i ( <br />.:> '��_ <br />...f...........Bath Z . <br />. <br />.. .. ........_Urinal //�1�� <br />................Plain faucet ineide h� � ' ? <br />c,ry �� �' f <br />................Side �snik wasLer @Y 0/� ��%Y � ��`. �� . <br />................Hose bib outside ' f!' F' ���� �� <br />i <br />................Hose bib for building pur�oses . TT f�, ��I <br />.............._ftose bib inside I . f�FQ�,� <br />/''> <br />................Bib for stable conteining....................stnll...._..........:. � <br />................Numbcr of persans in family - <br />....�.�i.........Number of rooms in building . <br />The Premises are to be uaed as �aA......'_ ........._ .. ....... ........_........._�.—f................ <br />The owner cf the prer.mises �.X.c� ................................. <br />Thengent is .................................................................................................... ................ <br />This applicnticn, although aigned, ahall not be binding upon the City, until <br />�:ed by tl�e Superintendent of thc �V�ater Depnrtment. <br />SiEned.i.�'.r.�..f.�e....Ci.1 ...s���-.r� .. .. ........ . ..Ap li t <br />i� �j�� � � i - <br />,�ted..� .�. .. . . . 'J2...... BY.. ....fYy�..�.. .. ..: . ... <br />� j ent... <br />