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r- ��, 1: J..5 r;,�j . -�-�,,�,�� ti'-I b-'1�(1n � <br />N'. D. Fnrm �—IfOU—E.C.Co.—L-:6-2/ <br />City of Everett'--Water Department <br />APPLICATION FOR WATER <br />All Llnnks must Uc filled in or crossed out <br />. I:��crelt........ ��°.. . 7. 5.� .................................192...... <br />TO TI3E SUPERINTBNDF.NT OF TIiP•. R'AT.R llEPARTAIEN'P: <br />CITY OF EVE12GT7� <br />I hereby npply for the use nt �cnter in nccoru e with thc ruies and regu- <br />Intions of the Nnter Depnrtment, fnr purposes nnd ��xcm�es stated bcla�v. <br />During lhc time that any of the �v�ter muins nmy Ue lnken up by rcason <br />of nn_ intprovements nuthorized Uy Lhe Cih• o[ Gcerett, in or of nny streeb or <br />iJlcy in ��hich they mny have been lnid, the City will not be required to furnish <br />wnter Juring the progress of such improcem^nls to nny consi�mer whose supplY <br />mny �hvs be cut off, or be lin� for nny dnn:nges for its fniiure so lo do. <br />Applicntion No...��....�'3 ......................... <br />Block...��._� � �� Lot........ ' � . Add._........_....._....._ ................ <br />..............yyy........... <br />................... ... .. . <br />No...... . �cLi�....�.�...._...._......._..........Street <br />..... _ ............. _�..... _........................................................................ _... .... _... _.......................... <br />The �vork l0 6e executed Ly ................___ ._.._._........-__............._.._.......Plumber <br />State sizc of tnp. �!�� � O�- <br />... �?:.....Tnp to be inserted in lhe niain. <br />..._�.........Wntcr doset <br />.._.L.........Both . <br />...._4.......Urinel <br />.....1.......Plnin fuucet inside /- <br />........`..:.....Side �vnik n•asher C. � � <br />._...(........Hosc bib outsidc ✓ � / <br />.........`....._Aase bib tor building purposes <br />...... �......Hnse bib insidc <br />._._4-...Bib for stablc contninin�.._ ................stnit....._............. <br />......_�-..Numbcr o[ persons in fnmily <br />l <br />.....:�.......Number of rooms in building ' , <br />Thc premises nre to be used as n._ .... .� �-A'- <br />...._ "-�1� ........._ .......................... <br />The owner of tl�e prer.iises is........ ..� .... ...CJ-��..5..:!:�..........._......__._... <br />^'hc ngent is ...................................................................................................................... <br />'.is application, althouRh signed, ahn -q ot be binding upon the Ciry, until <br />'ed by the Sup i tendcnt of the �V t¢{� Depnr ent. <br />Signed.. .p�....... .�-./..N./�� .. ........................ .: ............APPI"a�` <br />, /�'` / <br />_ L�- r�l� _ �.. ......... ...... <br />,�., /�. �� ....... <br />intendent <br />