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� <br /> .uF�. �-.zz -1,-�r ��..t � ", ,,;, <br /> R'.D.F'orm J–150U--ti.P.Co.-6-:G-T.A <br /> Citv of Everett^-Water Depai�tment <br /> " ��.�. � :�ATION FOR WATER <br /> All Ulnnls must Ue fiiled in or crossed out <br /> .. <br /> i./� Gceretl......................._.............�._...y............192..� <br /> TU 'PIIG SUP�RINTL:IDENT OP TIIF. R':1TIsi2 DEPAP.TritiNC: � <br /> CITY OR LVEP.ETT; <br /> I hereUy npply for the use of�vater in necorJ:mee wilh tlie rules �ud regu- <br /> latim�s of thc R'nter llcpartment, tor pm�poses and Cixtm�es stated bclo�v. <br /> During qie time thnt tmy u[ U�c tvatcr mnius may be lnken up Ly rensmi <br /> of nng imp�roecmenls nutltorized by thc City of Ererett, in or of nny strcet or <br /> ullcy in n�Lich thep mny hn�•e Leen laid, thc City will nut be mquirnd to furnish <br /> �cntcr during Um progress uf such improvemcnts Lo any consumcr whosc supply <br /> nviy thus Lc cut nft, or U}S(•'1y('nbLlJs. fa :in5• damnges for i'.e fnilure so to do. <br /> Appliculion No._...._..".../....!....�......._ — 7z O S <br /> / —� ''� L .n <br /> Black....._......�...�/.................... Lot............/.'S.................... Add..`T..s ... .......... � <br /> �. �^� �.�� � '`-�`�....-_u- <br /> No......__�..J.�...._....f....."-':...`�.�"..vl..........._Strcet � <br /> .. ...__._ . .. . .. . ........ _.. _... .. .... . _.. ... .... . � <br /> Thc �vork to be ese�uted by...... .. . _.. ...�..�-�.......PlumLer . � �.�-.t �i �II �':I� <br /> Sl:µc sizc of tnp. <br /> (/ rr <br /> ..�.Y.......Tnp to be inserted in tlic main. � <br /> . � .\Vntcr�closct i�/ <br /> .......�._....BnHi , \� . <br /> .._............Urinui � / � �� �' <br /> ................I'lnin Am.•et inside �1Y <br /> _._...........Sidc �enik �cnshcr <br /> ................}lase bib oulside � <br /> .._............IIasc Uih for Uuilding purposc, .��� <br /> ___..........IIose Uib inside <br /> ...._..........Bib tor stublc contnining...................stnll.._..._..._..... <br /> Numbcr of persmis in fnmily <br /> ....�_._...\nmbcr o[ roams in building . <br /> 7'he premiecs are to be used ns n...__..... .. . ,._. . ___...�...._p..�........................a- <br /> 7'he on�ncr of the prcr: ' es 'F< ..� ._. .....�e�.-C�.-a-�Yv.4.. <br /> Thc ngent is.............. � . ........._....... <br /> ............../..`. . __..... . .._..................................... <br /> This npPlicntion, nithough sikn^d, shnll nat be Uinding upon tlie City, until <br /> nccepted Ly the Superintendent u[ V • Departmenl. , <br /> --- <br /> Si 6 n e d.................. ........._... ....... ....�....................A p Pl i cmrt <br /> Accepted.�...-�.�....:...�..T..�%_1�J2..._. By..�. _ ..�}1�..... <br /> . ........................ <br /> _�_ Superintenden6 <br /> � <br />