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G_�r ' .. �'— Ol— < ] .C_� C'iJ-T'Tj /^<.—��^�- <br /> •W. D. Form� I500 7-I-17 C.P. • <br /> CITY OF EVERETT-=Water Department <br /> Application for Water <br /> All blanks must be filled in or crossed out . <br /> / 6 - S <br /> Everel[�____"___'_'__"'_"'..�J--_."'_"'_'_19�_7_ . <br /> 'CO THE SUPERINTENUENT OF TNE WATER DF.PARTMENT, <br /> CITY OF EYERETT: . <br /> 1 hereby apply fnr the use of water in ac[ordance w•i[h the rules 2nd regula• <br /> tiun,ot The Water Dapartm_nt, for purposes and fiztures stated 6elow. <br /> During the time that arty ot the watcr mains may be taken up by reason uf <br /> any�improvements authorized by Lhe City ot Everett,in or ot any strcet ar alley in <br /> which they mxy have been laid; the City will not be required tn (urnish water during <br /> the progress o(auth improvements tn any consumer whose supply may thus Ae cut <br /> nH,or be liable tor any damages fnr itx f�ilure so ta do. ' / � <br /> APPIi;:�tinnNo."""'�'�__ � ' . <br /> ___'__"' <br /> Blcek --.�-I2'`�U-/--'--Lot�--1�q�"--.�_�.r�.c'---Ad<I_---..-"-------- . . <br /> ?Jo.____.�-7-e�-L�._ _(.f-44-t?_—.�9_____"""_..S[reet <br /> ""-'-"---'---"-' . --"-'-"' .----'--------'----"-""-"'----'-'— <br /> 'fhe e•nrk to Ix executrd bl'--'--------'- -----------�-"'---'-- Plumber <br /> St�te sim ut tap. � o <br /> _�ly,�_.Tap to hr insrrtc<I in[he main. �� �� i � <br /> 5 � <br /> '-_--�__Water closet � <br /> '---f--.Bath . - �. ' <br /> .--_ Urinal � '�� <br /> - '_'-'-Plain taucet in�ide � ..'_�.r� \ <br /> __Side walk washer ��a� <br /> .._Hosebiboutside - , ��I�p�a <br /> ..____ __Hose bib (nrbuildin� purpases '�.I" , ,,I�/. <br /> .____'__'Hosebibinside �. � _._ ... .'.,���%• <br /> , . <br /> __"""._IIibtorstablecuntaining._"_"-"'-stall_-_�._'�_•---..� �.:.. <br /> . .__...._�.. <br /> ____..____Number ot perams in lamily <br /> ___J�._.___Number a(ronms in building <br /> Thepremiaesarctobcusedasa_____ _____________"..__"_.____'____ <br /> 'Phe nwner of[he premises is ..'__'_____"__._.__......_'____._"'_""._'_'. <br /> TheaRentis ."_____.._.__"'______'_ ____.'._"'._"'_.__""___" <br /> This application,:JthouK>>s�kned, shall not be hinding epan the City, unlil ae <br /> � cepied by The Superimenden of the Wnter UAeparlmcn[. <br /> 7 /�f`�_ <br /> Signed`- _"L`"'j,X/�1�'1__-_..L .__"'__.__Applicant <br /> � � I <br /> • Accepled_ �____`./_______ +�_, Ry(�v__'_____'..._"___'_____ <br /> ' i/! --.`. " surerinienaer.t <br />