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4 <br /> �.ti,�-�, .��� �-r%r/ . __ , �-,�-�`-� ll- r S -�'� Y��, <br /> R'.U.Pnrm 4—:LnU—F P.Co.—G-:G-:G � y <br /> City of Everett�Water Department <br /> APPLICATIOI� FOR WATER <br /> All binnks must bc filled in or crossed out <br /> livcrett......................���..l...................................ID2..�o <br /> TO TIIli SUYBRINTENDLNT OF THE N:1TER DEPARTnSEN'P: <br /> C1TY OF EVliB�TT: <br /> I Lereby ��p;:!Y for the uee ot n�ater in uccordance �vith the rules nn<I regu- <br /> lutions of tlie �Vater Depnrtment, tor purposes .�nd fistures stated below. <br /> lluring thc timc that any ot Lhc �satcr mnins mny �n orkof nn �st ect9� <br /> of nny imFrovements autharized by thc City uf F.cerett, Y <br /> ulley in which they m�y havc becn Inid, the City will not bc reqnired to furnisli <br /> wnter during the progress of such im;:rovements to nny consumer �shose supply <br /> may lhus bc cut otf, o(r�'b,c�-l-in�pb�lc�jpor any damnFes fpm� its fuilure so to do. �� <br /> Applicntion Ne.....Q..✓.�� G��.(R�.....` 7 �(Do • <br /> Bbcl:.........��'..7................. Lot...._...�<.�..�._�.............. Add... .....__. ... ____.. _._... <br /> - No..__�_��.Q......_..—.-.�U....................................Street <br /> rti.. l � <br /> ,rll"y �....�....5....�...].....`...1w1............................. ..... . _..._ . ........... <br /> ...a�.!..!._._............ <br /> .._...._........ <br /> The work to be exccuted by.... ..._ .4` L..._.. ... .. . __._....PlumU,er� / <br /> State size of tap. �� �`�j i�/ � U. <br /> ......���TaP to be inscrted in ihe main. ;� .�,� � <br /> .,_,,....�_...\Pnler doset S-'-Lwy10 <br /> C� I <br /> .........f.....Ba[h � 5S 5 $ 5 <br /> ........._�.Urinal .- � . <br /> ,,.......�-..Plain fnucet insidc '�� "'� <br /> ._........�Sidc wnik �cnslicr . <br /> ..,_.....(.....I�ose biU outside <br /> .,........`.-Ilose bib for Uuilding purposes <br /> ...._......`....Hose bib insidc <br /> . ..._-...BiL for stuble conlnining............_......stall......_............ <br /> _....-..NumLer ot persons in fatt�ily <br /> ..���...NumUcr of rooma in building �� J� <br /> ., iremises arc tobc used e= a. .. ..._.._. ./._1..:...._.�.�......-.... -/...........//�, <br /> _ o�vner oi the Premises is.....(�C.Ny�(-����'`i��-��-L���`�"�L <br /> .; • � ...................._... <br /> .e ngent is............................................................................................. <br /> ,iiis applicatien, althoufih signed, shall not be binding upon Lhe Ciry, until <br /> �pted by the Superintendent of lhe \9nter Department. <br /> SiBned................ ........................................ ............. .. �... ....ApPlicant <br /> Accept^d__.��.'.�..�.�.....-'......102lv. By. . ..... .......... <br /> .. ... .. ... .. . . � <br /> uperinlendent <br />