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�; . <br /> �^ ��,- ,- , . , � . ' �,%�.la,��� b— I - z<, r.�m <br /> � W.D.Fnrm 1--Ib00—E.CCo.-6-2G21 � ' <br /> City of Everett-�RTater Department <br /> APPLICATION FOR �TATER <br /> All binnks mast bc Silled in or cross� out <br /> G�r � <br /> Evcrett�.................................................. ......................19?�..... <br /> TO TI�E SUPERINTENDF.N`ITY OF F.VERETT DEPARTDIF.NT: <br /> I hereby npply for the use of a�ater in accordimce �cith thc rules and regu- <br /> Intions of the Wnter DeFartment, for pwP��es imd fis[ures stated bclow. <br /> During thc time thnt nny ot the w:der mains mny be tnken up by rcoson <br /> of nny improvements authorized by the Citv of E�•ereLt, in or ot nny strcet or <br /> ¢lley in whreh thcy mny have bcen lnid, the City will not be required to furnish <br /> may thus�be cut ott,or be linble forna�ny dun nges�for yts�fi il r��eo io9ao um>�r <br /> ppplicntion No.......�.'�.1.�...........1 I <br /> .._ Lot. . Add.........._. ._.__......_._........ <br /> aia�k............._�........3...... ............................ <br /> � Stmet <br /> No......... . ...................... <br /> ��....� ........_....-.' ... .... <br /> . ........................ ......__.................. .................................. . <br /> .......TLe wark la be executed bY..........-....--....-....... <br /> . _...........__..........._._......Plumbcr <br /> $},n s�ze of tap. J <br /> �"a�, �,Tnp to be inserted in the mnin. p <br /> .�� :.. `� � . <br /> .....R'nter.eloset <br /> . �.� <br /> Ba[h /� `h �' <br /> ...—� ......Urinnl � �1/, " � I <br /> ......:... <br /> ..._...✓Plnin inucet inside <br /> l� - <br /> ......—..- Side �valk washer <br /> ,....-...-2�osc Lib outside <br /> .._�-.:._Hose bib for building purposes <br /> ._,....—....Hose bib inside . <br /> .............. <br /> ..Bib for stable contnining....................stnll.�........_.. <br /> ..._-;J.. A'umbcr of persons in tamilY , <br /> .......(.c....Number of rooms in building p <br /> n [ ���- 1 <br /> The premises nrc to be used ns n..._. .../.."�•�� ��������� - <br /> C c.�...... __ ,s�.:i...�..a-.�-..:.. L.__.. <br /> The owner of the prcr.iises is... ,- <br /> � <br /> .......... <br /> _, <br /> T�e ngent is...................... ............. ........ .................. <br /> ................ ............ <br /> . .......... � <br /> ��'�•�s applicntion, nithough signed, shnll not be Linding upon the City, until <br /> ; _ , �.. � by the Snperi ndent of the tcr De nrtment. <br /> P <br /> . .........;.,/.: .... .. PPh t <br /> �gned.....................C.^ ...................���.. .. . . : <br /> , Sb_d.�/ "�.'..i�� ' .. ................... <br /> ..............192...... BY-.. �' <br /> :,., .......... . r.......... � ermtendent <br />