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• - i . _ � — -., _ . , . L�.v'>y / 1 -i � <br /> . _ � � <br /> \V. D. Form 1 I500 J-I-17 G.P. • . � � � <br /> CITY OF EVERETT-=Water Department , <br /> Application for Wat,,er <br /> . All blanks must be Iled in or croc+ed ou[f� <br /> F.vcrelt..._.'._""'______"'/�."__'_'_'_1�_'L <br /> TO THE SUPERIN7'ENDRN7'OF THG WATER DEPARTMENT, <br /> CI1'Y OF EVGRE7"f: <br /> I hcreby apply for tlm use ot water in �ccnrAance with the rules and requla- <br /> tiun;of The Water Depar[m^nl, (nr purposes and fix[ures stated below. <br /> During the time thac any of thc water mains may be taken up by reason of <br /> any improvementa authorizr�' or the City of Everetp in or ot any street or aUey in <br /> which they may have been IaM, [he City will not be required to turnish water during <br /> the proKress ot such improvements[n any consnmer whnse supply may thus 6e cW <br /> off, or bc liablc(or any damages( r its tailurr so to dn. <br /> Applirn[inn No._�6 �� � <br /> ""I/__. _"_____' <br /> Rkn:k y3- --pyr---/-L7o�t�'--�—��-�_'--._-':'_-'-.�dd----�---"'------ <br /> Ko.'_"���lJ , "N"!!J�.c�""'"""'__..Street <br /> -__'_'_"'.__.___"' . _'__'_""_._ _.'.__.__""'_______"""""_"""__" <br /> 'fhe Hork to 6e execu[e' h}'__'__'__"'___ _._____'_-'_"____' Plumber <br /> Statc size of tap. , <br /> � � /�VO <br /> _?�__Tap to be insertea in the main. <br /> �___Nater closet / <br /> .' "�____Dalh <br /> ._..___ .Urinal <br /> .. _______Plain taucet inside <br /> ._._.____Sidc anik washcr � , <br /> _._____.._Hose bib nutside <br /> ._________Hose bib fnr building purposes (� . <br /> \ <br /> ._____.__Hnsebibinsidc ' <br /> -_-- -"[3iblors[ablecuntaining._______.stelL__."' I�� <br /> .7 Number u[persnns in famil�� �� <br /> _`_.✓_____Numbcr nf rnoms in building ' <br /> Theprcmisesarerobeu�edasn'______."____"__"_.'_______________ ___"' <br /> The o•.vnerof thepremisesis ""_.._____._.__.__________________'___'_ <br /> Thc aKent is .""____'.'_.. ._"" <br /> __"'_." ...__".__""'.__..._________"_ <br /> This applicalinn, although siKned,shall not bo hinding upon Ihc Cily, until no <br /> cepted by The Superintend [o(t6e tValcr cp.7.7�k�i en�. <br /> Sipned __�q��L�!�(.�!!N�Y.LO�YK/____"Applicant <br /> Acttpted.- ___._ <br /> _"'.___191 k' ._--__ _'__..__'_"__'____ <br /> �• / - . ^J� '�--�/ Supetlntendent <br /> � ?G7"+� <br /> �i/ \ <br /> . • <br />