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CF�-rb }'1>.��.17f. <br />_ Fn�r�7 /-�7 1s-�J <br />~N'.D.Forn:—IfaO—E.P.Co.-6-28-2t • � <br />City of Everett�--Water Department <br />APPLICATION FOR WATER <br />All binnks must be filled in or crossed out <br />Evcrett,...........� � 2 S . .....................102...... <br />TO THG SUPERINI'ENDENT OF TH� R'AT R� pARTTiENT: <br />CITY OF EVERETT; <br />I hereLy apply for the use of �rater in accordnnce with the rules and regu- <br />Intions of the Water Depnrtment, for pw�poses and fixtures stnted bclow. <br />of nnyiimp�rocemeuts nulhor ed bytthe�City ofaF,9erett in orkof o y��' i ��iSOT <br />nlley in which they nmy ha�•e been laid, the City wil! not bc required to Yurniah <br />water during the progress of such imirrovea�ents to any consumer whose aupply <br />muS thus be cut off, or be linble for nny dx��mges for its fnilure so to do. <br />Applicntion No....c.�J..,3. / S <br />.. ....................... <br />Block..............1r.t_�r�',�.1.-.t........ Lot..i..�..........__................. Add.........._............_.............._. <br />xo..... `.Z.l...�.�...... .�.�..Ll..i..�.t�.t�ti...........Strnet <br />.... .... .......................................... ... . . .............. .. <br />� . . . . ........ ......... ... <br />. . . ...... . . <br />. . . ..... _ .............. _........ . . . <br />The work to be exeeuted by........._ . .a, . � .plmnber <br />. . ...............................`C��ir'�t- . <br />State aize of tnp. o � �y / <br />�z.....Tnp to be inserted irt th nin. /5^ � <br />.... �. <br />�����.�........Watcr closet <br />......i........Qath <br />..........`...�...Urinal <br />����� Z....Plnin fxucet insidc .� <br />�....Sidc R'LI}[ wnsher ��` � <br />........... <br />•�����/........Hosc bib outside - <br />������.�'....Hosc bib for building purposes f�' <br />�. <br />���-..L.....Hoae bib insidc . �' <br />i <br />.......`-. BiL for s[uble contnining ...................stall.................... <br />•���•���..-.....I�umber of persons in fnrt�ily <br />������.-....Number of rooms in building <br />The premises are to be used as a..._._._....���/� � � (/�_ � <br />.. .....�.:.-A.'.�,�;,`"' LS_ • <br />Thc o�mer of the premises is ...................� <br />............................ <br />. .. ...�.:.L.. J ...................... <br />The ngent is.......... <br />...... <br />'C�.1.�2......'�..f...... .. G . ............. rGt�i. <br />This ep�licntion, nithough sifined, shnti not be binding upmi the City, until <br />'pted by the 5uperintende^of ihe N�L��Depnrtment. <br />.....�.�,��..'..-.�3�C...... Ry...... <br />