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�.,,N- �- ��-.� , . <br />Y.'. D. Fbrm 1—tG00—HP.Co.-6-26-EI <br />�-c��.,�,� . � - -y � - �� r.�vv <br />City of Everett�--Water Department <br />APPLICATION FOR WATER <br />All binnks must be filled in or crossed out <br />liverelt, .............................. .1...."�..l�.........................192zS / <br />YO 7��AE SUPERINTCNDENI' OF THC \VATER DEPAP.Tn1ENT: <br />CITY OR EVE(2ETT: <br />I hereby npply for the use uf �cnter in xccardance with the nles nnd regu- <br />letions of the Wnter Depnrtment, for pm�poses nnd fis'ures stnted bclow. <br />During lhe lime thet nny o[ the wnter mnins mny be tuken uP �Y renson <br />uf nny improecments nuthorized by the Cilp of Ecerett, in or ot nny strect or <br />nliey in which ihey mny hn��e bcen Inid, the City a•ill not be required to furniah <br />wnter during the progress of such improv��ments ta ¢ny consumer whose euPP�Y <br />mny tims be cut ot[, ur Uc linble fur :my dmnnqes for its failure sa to do. <br />Applicntion No..._....._�.2..2.Z.... <br />Block.....................!.�.:..::......... Lot...............:........_.............. Add._.....:.... �......�.'.:.::............. <br />No........._�..�.� ................ .. Street <br />. ......................... <br />m <br />The work to be executed by......_....__.... .__ ..... ........_._...._......... <br />State size o: tnp. <br />/� T¢ to be inserted in the main. . <br />�L-.......... p � . <br />.....1�........R'ater doset '/ <br />.....7<........D eth � <br />. .............Urin al <br />..._�_....._Plain faitcet insidc <br />.....`...-..-.:.Side w¢IA «•nsher <br />.._:.`........_Fiose bib oulside <br />......—....Hose bib for building Purposes <br />.......�:.Hose bib inside <br />-......... .Bib for sSable containing.._ ................stall............._..... <br />......./.........NumLer of persons in tnmily <br />�r Number of raoms in building <br />.......Plamber <br />r- '��-�'" <br />i � ' <br />........ ..... <br />The premises are to bc used ns n..... /...� ..._ ._.. ....._... `. �J.-S....P..... <br />// - � p i <br />Tlie o�vner of thc premises is.......�..!..�.... �..... .�4...�t., i4�......_... .. <br />'ie agent is ...................................................................................................................... <br />npplicntion, elthough aigned, shnll not be binding upan lhe City, until <br />by lhe Superi�n'J�/ndent of thc �V ter epnrt ent. <br />SiEned..._�-'l�Gr�vvru.�.�........__......... _✓/l._.. . pplica <br />. <br />. <br />.. <br />cr� ,i..�./��--.....1'J2..�7.. BY ............... ... .���l� .................... <br />_.,,' $uperintendent <br />