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, �- , �. _ ,, <br /> _ � <br /> , <br /> W. D. Fcrm a I500 ]-I-17 G.P. <br /> CITY OF EVERETT-=Water Department <br /> Application for Water <br /> All blanks must be filled in or a�o,s�sed nut <br /> Ecerett.__.._'_'_'__'_-'___'_L_�:'!?_ _'_"'___14r'�__ <br /> TO THE SUPF.RINTENDEN9'OF THE WATER UEPARTMENI', <br /> CI'1'Y OF EVERETT: <br /> 1 hereby apply for the use ot warer in accnrdance with the rules and reRuln- <br /> tinns u(The Water Ueparlment. (nr purpnscx and fixtures stared below. <br /> During the[ime lhal any of the water mains may be taken up by reason u[ <br /> any improvemen[s authorized by [he City u(Everett,in or ot any street nr alley in <br /> which they may have been Inid, the City will not be mquired to lurnish water during <br /> lhe progress o(euch improvements to any consumer whnse supply may [hus be cut <br /> nif,or he liable(or any damiqes(or i[s faiiure so to du. <br /> _; � <br /> ApplirnHan Nu.__"'_'��,'""'_(""' <br /> O .� _ c <br /> Hinck G �—R- �—/--/.Lot_ri_7�.��--'�----'2-.f.Add---- - <br /> '_--' <br /> �j � /� - -----�-'-'-- <br /> hn..__Pl,_7�+ � _, LV,�2l�L/A_""""'".'.Strect <br /> f � <br /> "'"_"_'_'_"_ .""{_ ?_�/}'"'_____"_'""__"_"_"_'"""""_""_"_"'"' <br /> \ <br /> 'fheworkWbeexrcutedb'_.__.__'___" . -------------- Plumber <br /> Statp sizr of[ap. � � ri �. �L'o O^ <br /> 3�iE_�__T�p to be inserted in the main. � <br /> ____'.___Waier clnset � <br /> '___'__..Bath <br /> --_ .-_ .Urinal � � <br /> .._'_'_'__Plain faucet insidc <br /> . ..._____.Side w�alk washer <br /> _______.._Hose bib uutside <br /> .______..Hose bib forbuilding purq�ses � �' <br /> i, <br /> ..________Hase hib inside <br /> ___""'_'Bib for stable con[ainin�.____.__.---st:dl____ .__"' <br /> -'__._____Numbrr o!persnns in (amily <br /> _.__'__"'Numbcr af rooms in building <br /> 'ThePrcmiscsaretobeusedasa-__. _____"__'_""'.______________' ..__'. <br /> 7'henwnernflhePrmnisesis ___".-.."'____. ... _--.___.._-________' <br /> "CheaKenlis '__'_____'.._. .'_.'_'___'____ .. . .._ '_._.__'___. ..__.___.__ <br /> 7'hic applicntion.allhough signed.shall nut br binding upon thc City. unlil ao <br /> .cnted hy The Superimcndent o('hc Wntcr )epnruncnt. <br /> n e�7 <br /> SiNneJ .__ � � � C _. R-Ga-z-�✓—;� <br /> X �tc--/pr--L_1__WL .�"_'ApPlicantJ � <br /> AcceVtrd. �j �/'}y-' - 1' �j ' ' _". _' . .. ___"_'//"/' <br /> .-{ '1[J � �� 1�� S�.n•rimm� er.T t <br /> =� /\/ <br /> J <br />