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L�.=� -r�—b—�71�1: � 'E—,-:,tw—.) 3_ y g— :'i /3-;�✓� <br />W. I1. Form �-1500—F CCo.—F-26-21 <br />City qf Everett�--Water Depai•tment <br />� 1 �.'LICATION FOR WATER <br />� Alt blanAs mnst be filled in or crossed ou6 <br />i y <br />� <br />i Sverett ........ ........_............. ..._�:.:�.........................19z.� <br />TO TIIE SUPERIRT�NDGNT OF Tlli: R'Ai'1:R DEPARPnIliN'P: <br />CITY OF EVBRETT: <br />I 1�creLy npply for .he u�e o[ �cater in accordance with the rules and regu- <br />lations of the �Vntcr llepnrlment, for �,,,��o,os nnd fi�!ures st:�ted Uelorv. <br />lluring the time that any ot thc u•�t.er mains mny Ue tnken up Ly renson <br />of nny irop:oemnents nutho:ized by thc City of F.rerett, in or of miy alrect ar <br />nllcy in �vhich they mny hn��e been laid, the City �eill not be required to furnish <br />�en'sr during lUc progress n[ such improcements to nny cunsumer whose sunply <br />nmy thus bc cut oft, or L�e7 IinUcle tor any dnmages for its fnilure so to Jo. <br />Applicntion No..........b..�..d....Z..... —% / �'� / � _,�--}� <br />Block ........................................ Lot......................... ......_... AddL:1:u�-�_ -�-eL.(��L�1 <br />No......._�I..O.....�� ........... ...:....... ........ ....._ _ ..........otreet 1'ci. ��� 01'�V <br />... _... _ ... . . ........ _............... _......... .......................... ........,..,....../............ ........ _........................... <br />TLe work to be e�ecuted by.....__._..._ �:?--.-�-�......_ .................._..._..Plumber <br />�t, sjze of tnp. U � <br />� �/ Tap to be inserted in the main. �7, �� � �� o �� <br />.-....-.........Nntcr closet `��� <br />..._�.-..Dad� <br />IIrinnl <br />L��..Plnin faucet insidc <br />.`......:.:..Sidc «'alk �vnshcr <br />....—.-..Hose biU oulsidc <br />� --- <br />................Iiose bib for bnilding Purposes <br />iiosc bib inside <br />.......---::Bib for stnble containing ....................stnll...:..._�........... <br />... .._....A`umber uf Pcrsons in taroily <br />._1::/......NumLer of rooms in building � <br />Tlw Pl'emises nre to Ue used as a.... . .�... ' ; ��' <br />_r,_ \ �� .�..�...'�._.:\ ............. <br />The owner of the nremises is.........1�..._�..'......l.,.E'1 �/..:c_ ; �. <br />.. . ............................. <br />Thc agent is .............................................. .. � � <br />. ................� ...._...... ...: � <br />, � ............................... <br />This npplication, although signed, chnll not Ue binding u��n the City, until <br />necepled Uy Lhe Superin en ut of the Nater Depnttment. <br />Signed�._ `.�._:.V....�!...��... ... Applicant / <br />. � ., ..�...._.........._..........._._ ................... <br />Accepted......................................192...... By..................................................................... <br />Superintendent <br />