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-.i�t �. " _z3 L . E��i—;> -, <br />. W. D. Form a I500 J-I-17 C. P. <br />CITY OF EVERETTeCWater Department <br />Application for W//ater <br />All blanks mus gfilled in cro�jsed/�Lt <br />Ercrett. ��%�"�-" ( -___"____l� <br />L � <br />TU THE SUPF.RINTENUEN'1' OF'PHE WATGR DEPARTr1ENT. <br />CI7'Y OF E`IERETT: <br />1 hereby apply (nr the use of H•ater in acmrdance with the rules and regula- <br />tions nf The Water Uepartmenl, for purpuses and fixtures stated below. <br />During thc time thnt �ny oi Uie water m.+ins may bc taken up by reasun ot <br />:my imprnvements authurized bc the City of Everett, in nr nf :my s�rcM or alley in <br />which they may have been laid, the City will nol be rrquircd to furnish water durin� <br />the progress of aucli improvements to :my consumer whose supp�)' may thus br cut <br />nff, or he li:�ble tor anY dam:�Res (nr its tnilure so to Jo. <br />Applirntiu!,�n Npn�6_ �� <br />""_'_"'_ <br />Blnck.-v-8----' ---x'--L/�y ..��._�-�-�_..Add- ----�----------�-- <br />No.._�SQ� —�V_-Gr!7/(�t�0!ozC�"..Strecl <br />'__'____....___._" "__"__'_-..._.______'___.__________'_._"_" <br />'fhe wark to be execuled 6y-------""---------------------' Plumber <br />State/,5+zc nf t:�p. <br />._ •/__y._Tap tn be inserted in Ihe main. _�j / i`�G <br />v� d � <br />____ �__Waterdoset <br />.__.'� ".13at6 <br />_ . _ _ __ .Urinal <br />_ . _ _ _ _ _ _ Ylain (aucet insiJc <br />. _ ___..Sidc walk washcr <br />_______.._Ilosc bib outside <br />_ _ _ _ _.... - Hase bib (or 6uildinR perposcs <br />/ <br />_ "' _ _ _' Hosc bib insiJc '\ <br />____"_"'I3ibfurstablecmuaininl:------'.-._`tutl.... ___ ���� <br />._ Number ot persons in fnmil�• <br />, ._ __�Number a( romns iu building <br />7'hepremises;�mtubcusrdasa___________________'_'___'_____"__" _'___' <br />7'he uxner �•f the Prcmises is __"_' ___'____"'. -_.._. ___. _'_____.__""____' <br />T.hcaKentis "'"""""_" "__" """"'_"_"""'"_'_ <br />' Thie npp�ication, althouRh siqned, shall nut bc binding upon thc City, until no <br />,� . . <br />�.,, ..��,r..d b)' The Superintendcnt n( i\�tc�r )/��y�rlment. r,_ <br />� SiRncd__.��-/-J.._.�,_!c/---C�'�7r.�.�__''-�.�---"ApplicanJ <br />.,. AcccPtrd.�_L�_"_j� H>�_"___"'__'.__"__ll <br />�y snper!menem� <br />�+v , <br />�-. '�.f'i� <br />