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s <br /> Ct�7—,=� _/' 3/- .-13 'L ��viz) t-.2'!� _ <br /> - . . . .�!�� • <br /> N'. D. Form a I500 J-1-17 C.R . � '�� <br /> CITY OF EVERETT==Water Department <br /> Application for Water <br /> All blanks must be filled in or crossed out <br /> Eccrel[...._'_____.'___'_""' "2 L�_____.__l��_ <br /> � '_' <br /> 'PO THE SUPF:RIN7'ENUIiNT OF THE WATlili DEPART1fENT, <br /> CITl'OF EYERETT: <br /> 1 hrreby apply fnr the use u(water in :�cmrdance with the rules:md rc!(ula- <br /> tiuns n(The Water llepartment, (or purposcs aml fixtures stated below. <br /> Durinq the time that:inp u( tbc �vater mains may be takrn up hy reason of <br /> an)' imprnvcmenls authnrizcel bc [he City of Everet[,in or o( any sirce[ or �pcy in <br /> �ehich they may have becn laid, thc Citp will not bc required to lurnish water durinQ <br /> the pmgress o(such improven.ents to any consumcr whose surriy may thus be cut <br /> otf.ur be Iiablc for am•damage� for its L•�ilure :o to do. <br /> APPlicxtinn Nn.__�"6'�'�_ - I,'' - <br /> � <br /> Rlock __���----..LoL ----------.Add_.i!:),L:1�"-k/------ <br /> '_- <br /> No.___�_/-(S __ .Strect <br /> . _ - - --."'-' <br /> -----'-----------'- � --' �-------------'---_'-'-"-"-'--"'-.-"-'- . <br /> 'fhe work [o be exceuted by____ ___________'__'_'_"_'•"'____.__._ Plu�nber <br /> State size uf tap. <br /> -��-'----Tap lo bc inscrlcd in thc main. p -, p J <br /> --- I___'_1Yaterclnect ll�y �'�U �, <br /> ---�----Rath � <br /> -_. ---- .Urinal . ' <br /> .---..--_Plain faucet insidc � <br /> . .--"'_Side walk washer � <br /> --.___'.._Ilose bi6 nutsidc �I/�� ..� '.. <br /> __ ______Hosebibfurbuildingpurposes . . <br /> ..-______Husc Lib insidc � . <br /> --"".___$ibfors�abieconlaininp.____'______stall__ __.__ <br /> ___..._..Numberof pers�ms in familv <br /> y ----- <br /> Number nf rooms in buildinK � <br /> _ 'Phc premises are to be �sed av a____.f.� ��� <br /> � /--�--'_ '. ' _ __'____- <br /> _"" <br /> Thc uancr of the premises is _____'_ <br /> __-_-_________________________"_.__"_ <br /> Thc aKent is...__._.__......_ <br /> _.___'.'__.._ '_ ""'. <br /> "Phis application, although signcd, shall not bc binding upnn the City, until ao <br /> ceptcd bp Thc Superinienndenl uf the 1Vntcr Uc�p"artment. <br /> Signed 1 '�1� 1��� �U. � �i-��� .�ce.'-.c._�.>.✓,_____App ant <br /> '._ i <br /> epted_ / �/--� <br /> -./ :p•.,fl""'____'_'__'____. <br /> r+ � s�o•.�miene�m <br />