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� ��-fi ✓ 9 � i-S <br />�.r� rl_ '� . � , <br />L\'. U. F�inn 1—L•AO—E]'.Cn.—G-2G-21 <br />City of Everett--Water Department <br />APPLI�ATION FOR WATER <br />All Ui:mks roust be tilled i�� or crossed out <br />tivcrcit,.........._... �� 1 ....._../._ .:....................lf)�� <br />. . .................... .. <br />TO'PIIG SUL'�RINTPNDliNCITY OF�EVEiGTT;��EPART\IENT: <br />1 LereUy apPll' for tlie use uf w':ricr in accordance wilh the niles ;md reEu- <br />Intions ot the 1V:iter llcpm�lment, (or pmpu�es and fixtures �taled bi�lo�c. <br />Dm•ing thc limc lhnt nuy of thc �cnlcr mninc maY Ue tnkcn up by rcaaon <br />,.f mig in:ProvcmenLs authoriud bp Ihe City oC P:cerett, in or of �my �Lrcet or <br />a'atcr luringl�tl crProgt s�v�o[ such im�l�,ro cmCnts to1nny�cnnsunrer� �I�aefsu�iply <br />mal' thus L�� cut ufC, or bac 12in61c fm� an)' dawnBes for its fnilyre so to do. <br />Applicnt�on Nu......... p :J..C?0...:.... � I . , <br />_ . S Add. � � , � <br />I��} ..__.. �..__�.._ �. <br />Block.................._-T��....`�.p` _ I.ot............__._....... _._.... . � <br />No.._.cf.�-�'� �'�-�^'^'������`�..._..._...._........_..Street <br />... /.�/0O ..........__ ....... ........... <br />_._. _ . ....... .... .. ..... ..._....._ .. _......... .__. <br />Thc ���ork to be execnted by.__._... 1'lamber <br />Sta c =izc of tap. <br />q <br />.�......Tnp lo Uc insci:e� in tUc m:iin. <br />,,,;' ,.,^......`Puler closet <br />�7 <br />�_.-�3ath i�,� <br />.���.�_.Urinnl 1 "�,. <br />.......�..�. Plain fnucet inside <br />...............5`lc «'alk �cnshcr �.� <br />t--- <br />..._flo,�e bib oulside �' <br />__-.....�-i�lasc'�ib Cor Uuil�ling purposes <br />._, �-IIosc Uii+ insidc <br />.�-� <br />__._---.Bib for stiUlc wntnining........_...._.stnll........._.___. <br />,,.._. ..\umbcr of persons in faroily <br />,..�._._Number oi rcmus in bnilding � � <br />The Pi'c�uises nrc tu be used ns n� '�- � Q� � � <br />. . .... . .. _ ... � <br />The un�ner of thc premises is . -'�^^-+--� �� �"-�--v— <br />• . ................ _ _ _.................................................. <br />agent ts....__..__......._.........._...._... <br />. npplicdion, nlLhough si�ned, r.hall nol be binding upon the City, unLil <br />i..ed by lhc $uperintcndcut of lhe 1Vnter Depnrtmcnt. <br />Signc�(/si{yT��.....� �^����� % ;,� Applicnn, <br />,:��,,t�a . /,l -. �f''_ ioa.5.: Bv . l�� ,. Lqi,.Y•_'� _....._! <br />�upennlcndent <br />