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4 <br /> -�«� � -�f �9 -/r i �c«�i�_1�f�-/.e- r.�. <br /> r . � <br /> ' w.o.r•����—�coo—xr.co.-6 zs-ze -� .. <br /> City of Everett�Water Depai�tment <br /> APPLICATION FOR WATER <br /> All binnks must bc filled in or crossed out <br /> Everett........... ... . �.....�...:{..........102. ..f�.. <br /> TO TIIE SUP�RINTEND�NT OF VATER DF,PARTMENT: <br /> CITY OF �VERRTT; <br /> I hereb3' nPP�Y for the use of water in nccordance �rith tl�e rules nnd regu- <br /> I¢tions o[ +.he Waler Dep:irtment, for pm•poses and f?stures stated bclow. <br /> During the time thr.t any of the watcr mnins mn}• be taken up by reason <br /> ot nny improvements nutlmr'zed by the City of Bcerett, in or of uny strcet or <br /> ulley in e•hich they may li.iw been lnid, lhe City Rill not be required to furniah <br /> wnter during the progresv of such impro�•ements to nng consumer whose supply <br /> miiy thus Le cut otf, or br liapble for any damages for i.s fnilure so W do. <br /> Applicution No........(�.�A NS • <br /> ... �.............� S$ <br /> / � L <br /> Block.........:e�_..�.2....3.............. Lot.....� ...._..........._...... Add.:...r'l...l.....1...�_..�r:.:':...L <br /> ..... <br /> ���f ��e?� . <br /> No........ .. .. .. .. .........•.......................3trnet <br /> ... �.__...... <br /> _............ G 3iU ' ........_........................... <br /> ..............................._................... ............. <br /> The work to be esecuted by............ � � ....Plumber <br /> �� <�-._..�. <br /> Stat size of tnp. '�,,,.r�/;' . ` 11 <br /> ..�� Tnp to 6e mserted in the mn,� ( <�� 1���41�Yj <br /> ...... . <br /> ......�........\Vatet closet .I��I�. �. , � !:':.r:c G_... <br /> ....._ �.� �. ...,. , <br /> .......!. Snth -..:�� / <br /> �. <br /> ....... ......Urinal f <br /> ....Z........Plnin taucet inside <br /> -.....--......Side a•alk wnsher <br /> ......./........Hose bib outside <br /> ......"-...Hose bib for building nurposes <br /> ................fIosc bib insidc <br /> ...... ......Bib for staLle cantaining....................stall.................... <br /> ..-�.�.._T'umbcr of peraons in fnmily <br /> ....J�... ...Number of rooma in building <br /> The premises nre to be vsed ns a.............�<iQ......... <br /> ..................................... <br /> The owner of thc pretnises is......r.�1�.L,'.C�t..__.., . .�„��,�� _ �` <br /> �f.��....... <br /> Thcagent is....... ....................................................... <br /> ...................................................... <br /> This applicntion, alth�.righ signed, shul! not be binding upon thc City, until <br /> n�eepted by the Supc�•inti.r.dent of thc N�i¢,ter Department. <br /> Signed.�"......f.�lr0"/:.�......L�.:Gl�� ��............Appli nt <br /> / <br /> ��l�ted.......�..'...��..?�..-..102.. .. B <br /> � Y . .. . ............................ <br /> ,� Superintendent <br />