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�.....-.� k-� ��-�r . . �--�-ti.�.. 3- ��+--- . `;t r_ .,; . <br /> t�•.o.to.��--�coo—s.r.co.-6-2s-x1 <br /> City of EverettfWater Depai�tment <br /> APPLICATION FOR WATER <br /> All binnlcs must be filled in or crossed out <br /> 3.............................�s�.... <br /> E�•m�ett�1�:�'b..,....�.. • <br /> PO THE SUPBRINTI'sNDENCITY OF EVEBETT DEP\RT\SEN'P: <br /> I hereLy npP�Y for the use of wnter in nccordance with the rules nnd rega- <br /> Intions of lhe �Vater Dcpartment, for purPo,es �+nd fix�ures staSed b.loµ�•renson <br /> During the Ume th¢t nny of thc �catcr m¢ins may Ue taken up bY <br /> of nnF �mProvements eutharizc3 by the City of Ecerett, in or of r.ny strect or <br /> water dur n�ghtheeproF�g eof uch im;aro ements t��anY consum��rwho efsutiplY <br /> may thus 6e rut off, or be linble for :10}' �R111�gC9 for its fnilure so to do. <br /> Appticntion xo........_4.g._�..�-..........._— 7�9 3 '� C�S.{..._ ._-.�1 . <br /> �/ . Add._._....._. ...... <br /> Block......t�.Z..._�c�"...Q._._......... Lot.....�.... _..................._ . <br /> xo....1.3.o.�......_....._... ..__..._ . <br /> ...........................Strect • <br /> ..................._........ ....'..._.......^.__......__._.................... <br /> _..._...... ....._...................... , . <br /> �-- . I <br /> � a IumUer <br /> .....:. <br /> Tlic work to be executed by..... ........._ . �_, -' _ \ �� { �I <br /> C.: '. �,.M I <br /> S� e size of tap. �„^,�� \� <br /> , . _ � <br /> „ ..��......_Tcp to be mscrted m the ma�n.Ci7/ f,� t�,y;c�l f y.14�P'� <br /> ..__..[_.....Natcr closet (�, 7 , <br /> i <br /> . .:.._.........f. .�..,.� _. <br /> ......1........Bath j/I�� , <br /> .....Urinal . <br /> _«....Plnin f�mcet inside <br /> _._.`._^...Sidc walk washcr <br /> �' .....tIuse bib outsidc <br /> .....—_....Idose Uib for 6uildinB P�TPoses . . . . � :!:'r�" k,i� <br /> . ...�,,,,..Iiose bib inside <br /> J .Bib for staUle contnining....................stall.................... <br /> �.._ <br /> , �,,,,._....Nmnber of persans in fnmily <br /> .._�......Nun.Ucr of rooms in building ' <br /> _ _ . _._._...... <br /> .... ............................ <br /> T'�.< premises nre to Le usc es Lp�...�... . ���- � �� <br /> - �� �-��er of the prer.iises is.L.T...'-'.��1'!-'�"�� <br /> .. , ................................... <br /> • is.............................................................................. <br /> .... <br /> • <br /> ' ��n, althuu6h signed, shnll not be binding upon thc Ciry, unti <br /> ,.��_rintendent t lhe Nater Depnrfinent. / <br /> . ......�+i[i�✓7vt�..f.-7��C'n'I...�e1PPlican �� � <br /> . . .tr <br /> __ l� <br /> �v� �.. � <br /> :...... <br /> '/�192.� BY.. ........ . .......r.. �Up dent <br /> � • � <br />