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z..sJ i� �w �� ir < <br /> � �-�o-1-�F✓T j <br /> �V.D.Form�-1600—EF.Co.-6-2U2� <br /> City of Everett---Wa+�r Department <br /> APPLICATION FOR WATER <br /> All binnL-s must bc filled in or croased out <br /> Pverett................_..T..���.. .....192..� <br /> .. .. <br /> ............... <br /> TO TI?t; SUPERINTENDEN'f OF TFIG �VpTER DEPARI'BIENT: <br /> CITY OF EVEI.ETT; <br /> I hereby npply for the use o:water in nccordnnce �vith the rules nnd regu- <br /> lotions of the \Vater Dcpartment, for purposes nnd fi�'ures stnted Lelc�r. <br /> of nn}Dm�rovemmtm nuthor ed byttheµCity of�I•;vcrmett bn or�of� nny�strceb9or <br /> nlley in which they mny haee becn Inid, the City will not Le required to furnish <br /> water during the progress of such impro�•emcnts to nny consumer whose supply <br /> nu�y thus Lc cut off, or be liable fur :m}� dmm�ges for its fnilmro so to do. <br /> aPPlicntion No... ��„5. — 2 $ <br /> ..`.�...........� 2 <br /> Bluck......................................_ Lot....................................... Add..`.".'.�-'2�L'_h.`L�l <br /> f,� ' . ......... <br /> xo..../3..3.... ............... � .. <br /> . ......��`''�"/�����'�..........Strect <br /> ..................._................................._ . <br /> ..........._._............_............_.. <br /> .._ ._................................. <br /> The �vork to bc executed Uy......__._._....... . � <br /> . ...... ._...._............Plumber <br /> Slnt/e si?e of tnp. /���_ <br /> ��..fj.?-..Tap to bc inserted in the mnin. � <br /> ��,��_..�.......\Yuter closet . <br /> ........�.......Unch � � . �. . , „ i..�� „. <br /> ......... ...Urinnl ���� � <br /> ���...�:.....Plnin fnucet insidc ' <br /> .......... ...Sidc �rnik �vnshcr <br /> �---..�.......Hose bib outside <br /> ����—. .....Iiosc bib for building purposes <br /> ......... �...Anse bib insidc <br /> ........-....Bib for stnble conlaining....................stnll................._. <br /> �-�_.....`...Numbcr ot persons in fnmily <br /> -�..-.�-.....Numbcr of rooms in building <br /> The premises nre to be used ns n...._.........._.� � <br /> .........._..._......_........_...... <br /> ' � 'i" .�� owncr of the premis is........... <br /> . .._....................... <br /> .__....�._........._. ................. <br /> r ryu ��ent is.................... -�(i <br /> ... . . ..li1.�.`c...;c�.._.�-.�-__:/'.l._�..�- , j <br /> ....... �.��....... <br /> ..is npplicntion, nllhough signed, ;hnll not be binding upon the City, until <br /> '-�,! 6y the Superintendc�d oC the �Ynter Depnrtment. <br /> a'i gn e d......................Q�l <br /> ... ........ 1 . . A <br /> . ......... . .... . . PPlicnnt <br /> . .... .... . <br /> . ... .....-��. ...1F° .. B•... ' <br /> 7 __.� �........................ <br /> SuperintenJent <br />