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=...sa ��-�4 z-r �r • . <br />4—.-�1, �„_� .9� i �-; s-�� � t<, r�', <br />R', p, Fnrm �—���D—F..P.Co.—G-:6�26 <br />City of Everett�Water Depal'tment <br />APPLICATION FOR �WATER <br />All blimks must bc f�° °r crossed ont <br />� ..192.. .. <br />�vcrett ........................�........r%.cl........................- � <br />TO TIi� SUPERINTENDENCITY OF EVI'R�TT DEPARTDSENT. . <br />I hereby npP�Y for the u=_e of o'ater in nccordance with thc rules nnd regu- <br />l¢tions ot thc �Yutcr DePnrtmcnt, for pw�Poses nnd fis�m'�e tnken up'by reason <br />During lhe time thnt nny of the wnter mnins mny <br />of nny improvements autho:ized by tlic h�c�C tyEvill not�be�requiredYtocfurnisli <br />ullcy in which ihey mny huve bcen lni1, <br />muy tl us �be cu�t of f orQ41�e linble for ��iny� dni n Bes�for its�fa'lurc� so tog do uPP�Y <br />Q' -–�z3z- <br />Applicntion No......[J� � �...?�..... <br />y. �........ .. Add ........................................... <br />.. ot ................_._ .. � <br />nio�a............!%::.(..d............ . <br />c� Q / Q �O �j ,��..,e„/..�-..3trect <br />No........0�... .......... V <br />.......................... .... .... . <br />. __ _........._ ......................... ....... <br />....... . <br />.._.......... <br />. .. .. ... _ _........,..Plytnber <br />.. _... . .. . <br />TUc �cork to be eaecuted bY-- - � a �.� "� � �,(� ,/y(/ . U � �7Q <br />,:�, , � / <br />State sizc of tap. ---� .. <br />j,... /, � <br />_�/y.Tnp to be insc�ted�n tbo nixin: �� <br />� i. <br />� `' � � <br />.....L.........R'nl��r closet y, .. , j . � . <br />. /� ♦ <br />� <br />jv �7 <br />.....L.........BnUi �;r. . <br />..._....`...-...Urinat :Y.. � ��� �'�fCTIi�,y�, �,�}��;��DCP'j <br />(/ <br />...._�...Plnin fnucet inside..........�/..,,,,.,............... <br />i <br />......... ....Sidc �vnik «•nsLcr <br />.,,,../.......Hose bib outsidc <br />.._„_,-....Hose bib for building Purposes <br />.__...,-,... Hase bib inside <br />......... ..Bib for stnble contxininB ....................stnll................... <br />.,....,,`.....Number uf persons in fnmily <br />,_..�..Number of rooms in building <br />�9 �, __........_.._ .............. <br />.... <br />.. .. ... .. ... <br />The Premises nra to bc use ns e........... . <br />� _....�,�c�t. .. .. <br />- .. .... ....... ..... . <br />. „wne: of tUe Premises is ....... ....... <br />:.�ent i=_...._ ............................................ on the Cit9. 'mtil <br />.: apP��ention, althouqh signcd, shnll not be binding uP I <br />b the Superintendent of�tye ��y.�ter Dep¢rtment. t <br />—� Y�l. (SU.�-e.�. �....� . ... ..... .nn <br />� plitan <br />Si6ned................... .....:.. ......�............ � .... . . / <br />'� � 1 <br />. ,. � ..................... <br />AccePted...._�v..��.........1`�� BY'�..'... ....� uperintendent <br />