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T.u—� 6�1°'7"'t, f , . <br /> z�,e.�-G/ _ �[_�3-�.r• -;r <br /> \V.D.torm J-150V—E.F.Co.-6-2681 <br /> City of Everett-�Water Department � <br /> `APPLICA.TION FOR WATER <br /> All blanks muc,t bc fiilcd in or crossed out <br /> � Cverett,. . . .. _.._...� ...�...r.�........._....79�l..�... <br /> TO TISE SUPERINTENPENC1T1 OF EV 1 1'sTT;DEPART\[EN'f: <br /> I hm•eUy nPP�S forp ffie use oC��'nter in necordance �vith Uie rules nnd rngv- . <br /> IntionsDuring hectimethut�nny�of thc«af�er mnina mnY�be tnken'up'by renson <br /> of nny impruvements nulhorixed by thc City of F.vcrett, in or of nny eb�ect or <br /> nllcy in wh�ch thcYro ressRof uch in�Pr vemcits to�any c�ceumet�rwd�o efsupply <br /> e•ntcr during the p F . <br /> m:�y thus bc cut otf, or be cmble fpor any dmm�ges for qit�tnOSlure so to du. <br /> p�iplicotion No..__.._�._��...D....._.. " 3 / <br /> sia�k.... ?7 c......8..... <br /> . Add.._.........._..__.____........... <br /> ................... .......... <br /> _........ <br /> xo......... 3�-..15......... .... ._............ ..._.............. <br /> Street <br /> _ _................... <br /> .........._................._......_.._..... <br /> _.................. <br /> _............. <br /> " . . ...Plumber <br /> ..The work lo be executed bY.....__......�. .___. . .... ..__..........�........... � , <br /> (/ <br /> SL te size of tap• � � .J' <br /> , ,. 2 �°' <br /> .y...........Tap to Ue inscrted in tl�e mnin. � . <br /> ..,.,/.,,,,,..3Pnter closet <br /> � 1 � <br /> [. .....Bnth <br /> -.. ..........Urinxl 1 ���� . <br /> ........ <br /> �- ' � <br /> ................Plain fimcet insidc 4, <br /> ��....Side walk «•nshcr � •.� . <br /> ,.,, ..._....I[osc biF outsidc <br /> __—:....._Hosc bib tor Uuilding P'�rP�'-ca <br /> ........:.:.....Ilose bi6 inside 1� <br /> �-....Bib for stxblo con'nining......._...........stall..............q�-�. <br /> y......... �� , <br /> .-.-.............NumUer of Persons in iumily � <br /> dr'.........Nmnber of rooms in building ;"� � <br /> Yhe premises nre to be used n a.... � � <br /> .. _....................._.........�........ <br /> .. r __......_.. ..._ _ .. . <br /> The o«•ner ot the premises is... _ ...-...'.....-. .. .-. <br /> • .._..._..._......._......_................................ <br /> Thengent �s.................................................... <br /> Thic applicntion, eltLougL signed, shnll not be binding uPon the Cily, until <br /> nccepled ty the Superinten nt of theI,µ'+ater D mrtment. <br /> , (/� ^^-'�`"c""'..........�PPlican <br /> Si gn ed............. ................. .. ..... ...... <br /> ` ........192�.� BY._. ..�'�'✓ � . �. _ .. ...... <br /> .. ........ .... <br /> � .... ...r.... . <br /> Accepted..._.?�..-..�.�..�.1.. u • nt <br />