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rc�°-"\ i J - ,. � � (�. i <br /> , �.y-o . . -4��1( . . , <br /> W.D.Form�—�coO—EP.Co.-6-26�21 <br /> City qf Everett—•Water Pepartment <br /> �' � �ICATION FOR �WATER <br /> :ill bl¢nks must be filled in or crossed out <br /> � Z�S.........................192._?. <br /> veret ,.................................. . <br /> TO TI�E SUPERINT�NDENCITY OF EVERFTT;DEPARTA1cNT: <br /> I hereby apply tor the use of wnter in nccord¢nce with the rules and regu- <br /> lations of thc Water Department, for purPases nnd fixtures slated below. <br /> During the lime that any of the water maina may be taken up by rcason <br /> of any improvements authorized by the City of Everett, m or of any street or <br /> s11ey in which they m¢y have 6een leid, the rity will riot bc mquired to furniah <br /> wnter during the pmgresa of such impmvements to eny cansumer whoae evpplY <br /> muy thua be cut off, ot be linble for nny damages for its fnilure ea to do. <br /> C �7 l� 7Z �`� <br /> Application No.......Q...f.. �................. �,��(� <br /> Block........................................ Lot........................................ Add 1J�n_'--Jµ,R..:O.!l:/..i-,4 <br /> l� <br /> rro........./...��./...�...........�c��.............sn�c . <br /> .......................................................................... <br /> ..........`.._ <br /> ` ........ . ...._...................Plumbcr <br /> .... <br /> The woik to be executed by....................... .... . <br /> State eize of tap. �� � , <br /> ._.._�,�,'i.—..Tap to be inserted in the mnin. � � �� , <br /> _.,,_,_�....,Weter closet � � , <br /> -. ..,._.. . � <br /> ......_�......IIath . . ... <br /> _... <br /> . <br /> / <br /> ................U r�n n <br /> __,,,.,.-....Plnin fnucet inside <br /> ..,...._-...Side walk «'ashcr <br /> ,.._,. ......Ho�e bib outside <br /> _,_..,.'.......Hose bib for building Purpoaes <br /> _,..,, .....Aose bib inside <br /> `.......Bib for stable containing....................stall.................... <br /> ...._. <br /> .,.,,,.-:.....Number of pereons ?n familY <br /> _,,..�...Number of romns in building _ ,. �' � <br /> � /6�,��-rr.c�.�-..—..T........,✓"...:�x-�. <br /> The premises are to be uaed A9 e...._... ..�`.�. <br /> The owner of the pretnises is................................................................................. <br /> ..... <br /> ................................ <br /> Thesgent is..................................................................................... <br /> This application, elthouqh signed, shall not be binding upon the City, unGl <br /> nccePted by the Supedntendent of the Wnter Depnrtment. / <br /> i�—x—^��, <br /> L t <br /> ....... APPlican � <br /> Si6ned.....................................................................� . <br /> -..192..:] IIY..._ �. y... ... � .... . ............. <br /> . <br /> ...... <br /> Aceepted...._1...��.....'....`�2.-... � etintendent <br /> ! <br />