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4 <br /> • �>,k"v /z�`T^''a - o`t • � <<-�-C=�/' f). � -/0- i�- 3e ._�i . <br /> L , <br /> W.D.Form t--Ii00-E.P.Co.-��-2fi 21 � <br /> City of Everett--�Water Depai•tment <br /> AP�'LICATION FOR WATER. <br /> r . All blanks must bc filled in or crossed aut <br /> Et•erc LQ.__....._.............Ll/..�l..�j...�......._...19730 <br /> TO THE SUPERINTENDENT OF TISG R'ATCR DF.PARTb[ENT: <br /> CITY OF �VEI2GTT: <br /> I heteby npply for the use of�enter in nccordance with the rules nnd 1'egu- <br /> lations of the \{'ater Departmenl, for purposes nnd fi�!ures slated Leli,�v. <br /> During the time that any ot the water mains may Le tnken up 6y rcason <br /> of nny improvements authorizcd by the City oL Ecerett, in or of any street or <br /> alley in whirh they mny have been ln�d, thc City will nut be rnquired to furnish <br /> w•nter durin6 the progress of such im�irovements lo any consumer whose suPP�Y <br /> may thus be cut off, or be liabqle� for uny dnmages for its fnilure so tn do. <br /> APPlicntion No......��/ y �9� <br /> .. .................... <br /> Bluck.................,5/.��..�......... Lot.............�1..1'............... Add..�,�../��G�.................... <br /> No............� T..�.2..._...i��e.uris.�....9trcek <br /> ......_............__........--..........._..._...................................................._ ..............__................... <br /> Thc �vork to be executed by....,......_. .. . ......... _._... ... ........... i..Flumber <br /> Stnt size of tap. �jf � �/ oe - �i�;=�;. .� <br /> _� '`��`� '_ { ;/Di � <br /> J <br /> �..�..Tnp tn be inserted in U�e mniu. ; <br /> ......�.......F'eL:r doset - � <br /> ......�.......Iiath ' ,'. �� .. J �-_. <br /> ..... ....tirinal � � . . . '.' _`� <br /> ......�....Plnin fnucet innidc �"""""""."'-�. <br /> �.; .. <br /> ; ' /. ; �,: � <br /> ._....-......Side �cnik wasLet . .. <br /> , � <br /> ..._I.........IIo�e Uib outside . . ���� . ; . �.,� <br /> ......-:.....Hose bib for building Purposce � � � � <br /> ........—...IIose bib inaide <br /> .......-"-_....EiU for fitable containing....................etall.................... <br /> .... — Numbcr of persons in tnmily <br /> ..�..{...^....'. <br /> ....,,Y..:.....Number of rooma in building A1 <br /> The Premises nre to be uaed as a. .. ......U. LR .�J.�. ......... ��,�. ... <br /> The owner of the premises is _ ..tR.tp........ .�=[' <br /> . .. ..... ��a.z.:o�L.. <br /> Thengent is.......... .. .. .. ...... ...................................................................................... <br /> This npplicntion, aithoagh signed, cliall not be binding upon the City, until <br /> cepted by the Superintendeu: of the Wntcr Department. <br /> Sir,rted._�....... . O ...... . . . _ . . . _.. ... ppl�, t � <br /> � <br /> �tccep',ed.l...!��.-�.:..�L7....192...... BY..�" _ , <br /> � ����`.�;�'�r::�;�.... <br /> ,—, - <br />