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Zt.c�L`-r1 �/-'�, -3✓� " �..�1��.�A,_J-:e �. <br /> , <br /> \V.D.Form F—IG00—E.1'.Co.-5.2G�21 , � <br /> City of Everett�Water De}�artment <br /> APPLICATION FOR W�.TER <br /> All binnks must bc 'lle in or crossed out ii <br /> �' <br /> lverett,.........._ �'............19�C� <br /> ..................................r....... <br /> TO TIIE SUPERINTENllCNT OR THE 'ATGR DF.PARTniENT: <br /> CITY OF L•'VERGTT: <br /> I hereby npply far the use u[w�ter in nccardnnce �eith the rules mid regu- <br /> Intions of the Wntcr Depnrtment, for purpuses nnd fis!ures ,tnted b��lo�c. <br /> During tlic time thnt nny ot the watcr mnins may Le tuken up by rcasmi <br /> of nny improvemnnts nut6arized by the City of F,�•crett, in or of anv strcet or <br /> ¢lley in which thcy mny h¢vc been Inid, thc City will not bc re�uired to furnish <br /> tenter during the progress of such improvements to nny car.sumer whose supply <br /> m.i;. thus bc cut oft, or li e f r nny dnnmges for its fnilure so to do. <br /> Applicntion No.._......��.�...2....... - / Q,� J� , <br /> o �7 . / <br /> Blodc.....Qe.l!. .... Lo£ ...�i,l'��f'— Add.. "." d'*�ve�� <br /> ................ <br /> �y - _......__.._..,l................. ��,. <br /> ........................... <br /> O <br /> No..... ..._.......a..'.........�. .. ...__ ..........................Strect <br /> ...................................................................._.............................................................................. <br /> The �vork to be executed bY........................ ....___.............. ............__.._.Plumber � <br /> Stnt�/y_ize of tap. �,�Q/�J'-� .�(� G• 3, <br /> 3..y� 1'np lo be inscrted in the mnin.,��'��,.,.��/ � �`� <br /> �...... <br /> .............._Nnter closet • �.[ <br /> ................II¢U� _YF� ��_, .._..,� <br /> T� '' 1 <br /> ................Urinnl : � . � <br /> ................Plnin fnucet insidc � � . <br /> __............Sidc �enik «•nshcr �.,_.. � � '., r <br /> ................Flose bib outside . ........... �.�V,. � . <br /> .,...L._._ <br /> ......__....T1osc Lib for Luilding purposes 3p�1� <br /> ................IIo=c bib insidc w'� <br /> b <br /> _..............Bib for slnblc contnining....................stall.................... <br /> ....._.........NumUer of persons in tamily . <br /> ................NumLcr oI toonts in building <br /> The premises nre to be used ns n...._..... _...._... <br /> . _._............._.._..............._............... <br /> The o�mer of thr. pre�7ises is..........._..._....._.................................................... <br /> Theagent is......................................... .......... <br /> .................. ................................................. <br /> This npplicntion, c1!hcaqh signed, slinll not be bir.ding upon the Ciry, nntil <br /> 'l�ted bY Lhe Superinlc:.dcuL of lhe R'utcr DeparimenL. <br /> 7 <br /> Sisned..... .��.��J.L..:.��: _� ,�e� A p�nt <br /> , ..................r;...... <br /> A •cepted.._�.�.I-..�......3973�J BYt�.�.... 7��/ � <br /> ...'....J.`'�� . ... <br /> S__-�Zae���k / � endent <br />