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d <br /> !'i.-�X2�-��( '� r v /� ✓� �/I <br /> � . . 'C�cTd: il-y-'�5"�}1 ' <br /> � � R'.U.Porm b�IG00-E.P.Co.-G3G81 <br /> City of Everett�Water Department <br /> APPLICATION FOR WATER <br /> All binnl:s must he filled in or crossed out <br /> � <br /> � Everctt,................../ l.p. -�/�•`�'.2..............192..� <br /> PO THE SUPERINT�Nll�NCITY OI' E\�F.Ii6T1'; 'PARTilIEN'C: <br /> � I l�ereby nPP�S for the use of �cater in nccordnnce �cith tLc rules nnd tegu- <br /> lations ot the Natcr Dcinrtment, fur purpuses and fixfmrs s:nted bclow. <br /> During lhe time t�mt any of Hic w�tcr mnins m��Y bc tnken n-i by renson <br /> of nnS' �ro�icovements nuthorized Uy the City of ]:��erelt, in or af imy slreet ar <br /> aliey ir, whirh they mny hnve 6cen Inid, thc City will not be mquired to turnisli <br /> - �cnter during tLe ptrogress of such impravementa lo nny consumer whose supplY <br /> m:�y thus be cut oft, or be liabte tor ung dmn�iS�s tor its fnilure so to do. <br /> APP��ention No.... ... �O <br /> �3_L.................... <br /> ,:, :, - ...._....::_..::.:..:. <br /> Blocic................... .7.._...... Lot......_......._�...... ........._ Add............._ � �- <br /> No.........�...�.U.�._._.��.._....Street <br /> ..�........... . . . .a...�_.........._.............._... <br /> . . .........................._....................... . ... . <br /> ......_..._ . <br /> .......Tlic u•m•k to be esecuted by.__......... .l.�-C . ...........v...............Plumber <br /> State nize ot tnp. <br /> � /Y�"" /vr <br /> ��7L.....Tnp to bc inscrted in thc mnin. <br /> ,,,.�,,,.......Wntcr closet <br /> ...1...........Bnth <br /> .....-'.......Urin al <br /> ....2........Plnin fnucet insidc ,. <br /> V <br /> ......'.......Side «�nik «•nshcr <br /> .....�.........Hosc bib outside <br /> ......-.'......Hosc bib for buildin^ purposce <br /> _..... �......Fiosc biU inside <br /> ......�.......Bib ior stnblc contuining....................stnll.................... <br /> ,....1........T'umbcr u[ persons in family ���G� «—c_ <br /> ......��.. ......NumUcr of rooms in building <br /> The preroises nrc to be used as a........�.(LLvtN`=w����G��• <br /> The owner of the premises is........_....._.........___..._. .............................................. <br /> Tti� ngent is....._............................_...._._.._.............._.................................................... <br /> c applicntinn, nithouF�� <iFned, ahnll not be binding upon the City, until <br /> ,. I Ly the Superintendent of lhc R'atcr Depnrtment. <br /> Signed..d...........�..y,........`� ��'�.��.......Appli nt <br /> ,� <br /> ' � -•� 1�J'L_:..: BY._....�..:...................... :i...................... <br /> � d_. .�f_........:...... . <br /> .......,.. <br /> � . - <br /> "'�""""" S�uperintendent <br />