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��.� �_, � ..�-r, �, . ._ . <br /> ,�, r n �-� � --�� <br /> W.D.Form�-1600—&P.Co.—b-26-P� <br /> Citv of Everett-�Water Department � <br /> �ATION FOR WATER <br /> All blanke must be filled in or cross^d uut <br /> / a <br /> �verett...............`�r. ..ifGa..+:............../.._�................1'J2.A.. <br /> TO TIiE SUPERINTENDENCITY OF EVERETT;DEPART\SENT: <br /> I hercUy apP�Y for the use of water in nccordnnce with the rules nnd regu- <br /> Intions of the Water Department, fot pw•P�ses and fislures stuled below. <br /> During the time thnt eny of the water mains mey bn o kof anybst ceteor <br /> of nny improvements authorized by the h�eyC t w�ill not bc required to furnish <br /> nlley in which they mny hava been lnid, Y <br /> wnter durmg �he progress of such improvements to any consumer whose eupply <br /> muy thus ue r�. off, opr hpe lie lc tor u��'snyBes fot ita lnilure ao to do. <br /> ppplication Na._0�.0..� �.................. ,l' <br /> .... <br /> t..................................... Add.�+..^...��2..e_ ..�..0 <br /> slock............................... ..... . . <br /> No....�.��Q....._.._. ....���..............3trnet � <br /> .............................................................................................................._............... , <br /> . . . , . ...... .. .. ..._..........Plumber • <br /> The work .to be ezecuted by........ . <br /> State size of taP• � � <br /> � ' <br /> ._.�J".^faP to bc inscrted in ih mqi}I�N 1 � ��)�� <br /> ,,,,,[..,,....Nater cleset CI7Y OF EVciiEf7 WATEII G:M <br /> i : <br /> . <br /> Q ' <br /> ....1...........Beth Y....................,t..._....»......r._ <br /> / <br /> ....�.........Urinal ' . <br /> .._.,,-�,.-.,.,,..Plnin faucet insidc <br /> ........:.......Side �vulk wnsher <br /> ___,.../,........Flosr Uib outside ' <br /> ..,.._�......Hose bib for building Purposes <br /> ..,..�........Hose bib inside <br /> ..... ......Bib for stnble containinB........:...........stall.................... <br /> ,..,,-.......Numbcr of persons in fnmily <br /> ,.�..NumUer of rooms in bviiding <br /> V ,,.�. .......... . .......... <br /> The premises nre tu bo used es a.......... . <br /> ... ........ , <br /> �����................ <br /> The o�vner of the prernises ix........ .. .. . <br /> Thengent is.......:.............................................................................................................. <br /> This applicntion, nithoush signed, shnll not be binding uPon thc City, until <br /> accepted by the Superintendent of tLe Nater Depa tment. / <br /> �/ di2��...y.��....Applicant <br /> Signed...........�•!a'!'P.CGE".-„-�. ....:....r.....`. <br /> '/// .. .. <br /> ^ % _, <br /> /�/ � .......................... <br /> ..D...-......_i92.�. By... .. .. ...... punntendent <br /> Accepted.......�=..1 <br />