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E�+-.h-a�.�_�.' 11- y-'� ��1' f( la • • W�-�'-n..c��:.. c, - 3 0-.9 7 r.,�} <br />W. D.'F'orm i-160n--E.P.Cn.-6�26-2� • � <br />City of Everett�Water Depai�tment - <br />APPLICATTON FOR WATER <br />All binnks nmst bc filled in or crossed uut <br />Evcrett� ........................._�F �.�U...._... _........_.........1 �27.. <br />TO THE SUI'ERINTENI)ENT OP TIiE NATER DEPARTDSENT: <br />CITY OF EVERETT: <br />I Lereby npply for the use uf e•ater in nccordance ��•ith lhc rules nnd regu- <br />lutinns of thc Nater Depnrtment, for purposes nnd fis!w�er stnted belo�a. <br />During Oic time thnt nny o[ the water mnins mny Le tnken up 6y� renson <br />o[ nny improrements nulharized by t6e City ot F,r•erelt, in or of any street or <br />nlle>� in �vhich thcy may ha�•e been lnid, the City will not be required to furnish <br />water dw�ing Ure p�rogress of such imprnrements to nny consumcr whosc supplY <br />mny thus bc rut off, orpbc-7li/¢blc tor nny damnges fi�r its inilm•e so to do. <br />Applic¢tion No......Q..L.l....�L' ................. <br />Block...............�o/...��..I........... Loty.�...._!�.�.._..............._.. Add._.........__........____........... <br />No..r�.�-....i.C'...�-�..U�7.. �tt�r.-!-r.-��....Street <br />._........ _ ................................................................. _. _........_ _. _..._.... .. _.. _ _................._........ <br />The work to be executed by ....... ...... .G �. . .. ._. ., ......_......Plumber <br />Stnte sir.e of tnp. �� Q'�� �� 3'/ -, <br />..�._��.....Tnp to Ue inserted in tl�e mnin. T�� <br />...............\Pntcr claset � \ . . � <br />.....Bnch <br />................Urinnl / .-' <br />................Plain fnacet insidr �: <br />................Sidc �vnik �casUcr <br />................Hcse biU outsice <br />__.........._Ilosc Lib for building purpnsea <br />................Hosc Lib inside <br />............._.BiL for stnUle conlnining....................stall...._.............. <br />................Numher of persons in fnn�ily <br />................NumUcr o[ rooms in buildin� <br />Tlie prcroises nrc to be used ns n....�,y(<+�t�t.Lt.o_.._.�.(�«^�� <br />'Phe o���ncr of thc Prcmises is............ __.....__._..._... _ .................._._..........._._.. <br />Thcagent is ......................_....................__...._...._......................................_................. <br />This npplicnlion, nithough signed, aluill not 6e Uindiug upan the City, until <br />nccePted by the Supcy�irjte�dentl C lh�\�ter �cP��ent. n <br />_..�._ .1a1' 2...... <br />_ � <br />