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C <br /> �� rl-i�{17 /f ' <br /> • , `�-,-�-`-..�_.� �- :, - , • ��.: <br /> ;, <br /> W.U.Furm 1-I600-EP.Cw-6�R6-YI <br /> City of Everett�--Water Department <br /> APPLICATION FOR WATER <br /> All binnks must be filled in or crossed out <br /> ----�_ <br /> Everett,_......... 3.p <br /> ...�......................................... <br /> PO TFIE SUPGRIfi'TENDPIQT OF' TIIE �VATER DEPART\IEA'T: 1`J2� <br /> CITY OF EVGI;�q"r; <br /> I hereby nPP!S for the use of�cater in nccordance with the rules nr.d regu- <br /> lutions of the Wnter Depnrtment, for purposes nnd fixfures stnteJ bclow, <br /> o[ nnyllin prorements atithorizrd by�thcµCit� otuF.vcreti n orkot nrny�atreet or <br /> a0c,v in whfeh iheY mn�• huee 6ecn Inid, the City �vill not be rc�uired ta furnish <br /> �cnter dm•ing the progress uf such improveroents to uny con�umor �vhose suPp�Y <br /> "���Y thus bc cut nt[, oGr b7c IinbL for nny dnmpges for its Snilure su tu do. <br /> Applicntion No....p....(,.��q —7� q . <br /> Bloek........................................ Lot/.........................' <br /> .. ..... Add........... a—.' <br /> xo.._../_..3 3� �-� l�C.� �l`,�,"�_a.��� . <br /> .._...................._ ...c .............._...........Street � <br /> ......__..................... � <br /> ..................... . <br /> ......................... <br /> . .�_p..... <br /> Thc work tn be executed by......__..._ _..�. ..................... ............. <br /> Stnte size of tap. "-'� '��'- ��'_ -�-�-����•�p�umber <br /> l <br /> .��2r:...Tep to be inserted in the main. � <br /> .........�..._.Nater closct . � . ' <br /> .......1........Bnth - � � <br /> / <br /> .........-....Urinal � :. � <br /> -�-����::..Plnin fnucet insidc ��-'� <br /> ........-....Side wnik u•asLcr <br /> -^�����......_Hose bib outside <br /> ������.-�.._Ilose bib for buiiding purposes <br /> ���-�� .......Hose bib iusidc <br /> ...... .......Bib for stnLle cmrtaining....................stall.................... <br /> .......--...ICumber of pereons in fnmily <br /> � .NumLer of raoms in building <br /> .... <br /> '�:= premises nre ta be used ns n..... <br /> _. _J�� <br /> �_^ awncr of thc � ' ----� <br /> Pree ' s �s............._. <br /> _...............__......... <br /> agent is................ ..� � 1.!.................. <br /> ......., .... <br /> _.�.:c..c..✓,-c���.......... �E �f <br /> .. <....._w..�...,..... <br /> nppi�c:rtion, nithou�h signed, shnll not be bindin u un the City, until <br /> �� the SuPe+:^tendc� of the R'nter Uopnrtmenk P � <br /> . �. . . Sigued...............��-�.:� "�- <br /> � , . ................ <br /> . .i:.r.r.,.-...... <br /> A,c`.n" ' .�9 a. . ... Applicant <br /> w.._........... .....1D2.7 /... <br /> ' .. <br /> � IIy...... . %r� . / I <br /> . . �j�,./:..........._.. <br /> �, - f��superintendent <br />