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�Cla.� Y� ry� ] �' � . . _.�.�.�( 1 [ _.�.� !1 _ �: _ . <br />R'�U.Porm�-16o0—&P.Cu.-4:6.2i � � <br />City of Everett--•Water Department <br />APPLICATION FOR WATER <br />All blanl;s must tie filled in or crusscil out <br />lieerett�-..._/O .. .. _... ..� ......... .... ............192� <br />PO THE SUPGRINTI:NllF.NT OR T11E R'A1'F.P. DEPA12'SI6V'C: <br />CITT OP liVli1:CTP: <br />I 1-�ereLy npply fnr the •.ise ot wn[er in aceerdance o•ith the iiiles nnd regu- <br />lutions of the R'ater Dep:�rtn��±ni, far 7mrposes nnd fi�tm�c� stntrd bclo�r. <br />Dm�ing Q�,e lime thnt eny of t.hc n��ter mnins ma3' Le laken up US' rcasun <br />o[ enp imprucer.mnts nulhori�,.ed bc the City oC I:cerett, in or of any sU•eet or <br />allep in �chich thcy m�y hnve becn loid, the City �vill nol be rer,uired to furni��l: <br />water durin� ihe progress of such improcements to nny co;isumer �chosr supply <br />mny q�vs Uc cut off, o�rjbc li:wle for :my dauioges for its Tnilure so lu do. <br />Applicntion No.....p..�....�..rr ................. <br />Qlock .....Z...� . ......_QL'ot. ._..�._ /.. ........_ Add...._.... ...___ . ............ <br />No... . . ��..�.�7-tt�r<*. y . ...........Street <br />_...� �z .7._.._...._...... <br />_..........._. _ ...............................__........................ <br />T6c u•odc to be executecl by......_ __..%Y_ _. _. __.._ ................._...........Plmnber <br />Slatc size a[ tnp, � -., � <br />_?�n. _ <br />.�2....Tnp to be inserted in thc mnin. �%-'��'� <br />.....%......._\Pnter closet ,��...� � <br />..... /.......... I3 a t h <br />_..X........Urin�i <br />.-..`Z ........I'Inin fnucet insidc � <br />.....,�.....Sidc walk tvnshcr � .^ - p G -- <br />__�........Hose bib outsidc // /`5 — <br />..IIosc biL for builJing Purpo=es �� <br />...._.........}Iose biU i;�.ride <br />.__:Y_.....Bib for stablc contnining ....................stall.........._ _.. <br />......�...._.Nmnbcr o[ persons in family ... <br />.....f.�.....NumLer of rooms in Uuilding yyy��� """ <br />Tiw liremi=es are to be used ns n .......... ...r �1�e�. <br />1/) -C"` ..................._. <br />7'he owncr of tlic premises is......�•... �,� • <br />.. _ ...................._......... <br />Theagent is ..................._........_.....__........_... <br />. ................_.............................................. <br />This nt�plication, nithouqh signed, shail tmt be binding upon lhe Cit <br />nccepted Uy ihe �u7irr' � endyc�ut oC t�// q'ater DepnrtmenL Y, until <br />• Signc�..�..,...U✓.dw'.!w....l.........._._ ................... <br />� ! . f <br />�..........A licunt <br />, • •_.•1 ...�.:.�..c.�� By... :... �V'�G�'� <br />tr'� ......... <br />_ _ � .. endent <br />_� � <br />