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E N7-Jj �-�n-z � /�. <br /> E..i7"D L;'iN—A`-"—it( . . � <br /> \V. D. Form 1 I SM �-�-��C•P• <br /> CITY OF EVERETT==Water Department <br /> Application for Water <br /> All blanks muet bc filicd in or crosse��u[ <br /> lri <br /> E��crett.-=�� ' � . "__.._._19�7� <br /> - 7.'_'.'..' <br /> "f0 THF.SUPERINTENDRN'C 01�'PfiG WATER DEPARTMENT, <br /> CI7'Y OF F.`IBRE7'T: <br /> 1 hereby app�Y G�r the use n(wa�er in acrnrdance with the rules:md regula� <br /> ti�.ins of'1'he Water Dep.irlm�:nt. for purpuxs and (sU�res slared belo�e. <br /> Darin� thc time thnt any of the waler mains ma}'be taken up by reason of <br /> :mY imprnvemm�Cs authorizcd hc thr Ciry uf Everett,in or nl any S�rcel or aIIrY in <br /> which thrY �»�Y have becn IaiJ, the Ci[Y��'ill not bc required to himish�'ater during <br /> the Progress o(such impruvements to any consumer whose supply mnY thus be cut <br /> uff,ur bc liable ior any damaF�• f�r its (nilure so to do. <br /> �a �' <br /> Applicntion Nn.' __' "----'- <br /> 131uck _' " ��'//—S�/1-. Add_"'_""_'_""'__' <br /> �'- ""_ '_ "Lnt_""' <br /> — __'_..Strcet <br /> .�. _.���a- -- -��`-�,`=`�-------.. <br /> -----�-- - ----- --- ----- --- ------------------------------�------ <br /> 'fhe wurk to be esecu�cd by.-_._._'______ '_.____ __•'__.__'_'___ Plumber <br /> Stnte sizc nt l:�p. <br /> __�?-�_T�p ln 6e insrrted in the main. <br /> ,_______.�Vater dosct <br /> � .__"___Bath <br /> ---. -"' -Urinal <br /> -.-'--'---Plain tnucetinsidc <br /> .____""_Sidc w•alk washer <br /> ________.'Ilasc bib outside <br /> ___."____llose bib (orbuildin7; P���P��ses <br /> ____._____Hose bi6 insi<le <br /> ___'_""'I3ib for sWble cuntaining._._____.._.slall__'.-""' <br /> . __'.'__'.Num6cro(persons in (amily <br /> -'_'_'__'_Nwnbcr uf ronms iu building <br /> The premises are to be used as a__._..___'_"_"__""._"""_"____' _'_"' <br /> Theownernf[hePremisesis _'-"..'-'______.__._.______"__'_____'_".____. <br /> Thea6entis _.."'__'_____ ________'.'__'_"..____'____ <br /> .""____...__ <br /> 1'his npplicalion, alUiough signed,shall nut 6e binding u�m the CitY. until ac <br /> ccptcd by The Superiniendcn[of the Wnter UcpartmeN. <br /> Signed��._W-�--�--- ---�-- ---- "--'---�—APPlicant <br /> :\aepled..._....__.._____.191 By.__'__.__________'_'_'__'___- <br /> SuperimenCeei <br />