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en ,� ,-�y-ys-,�/ °�v;�,..i.f .— ,- :.r_ �,,;✓ <br /> ' : .i <br /> W.D.Form�—If00—E.P.Co.--4-26-21 <br /> City of Everett--Water Department <br /> APPLICATION FOR WATER <br /> All blanks muet be filled in ot crossed�oat . <br /> Everett,...............................'.......1......L.......................192.� . <br /> TO THE SUPERINTENDENT OF THE NA1'ER 1)F.PARTMENT: <br /> � CITY OF EVERF,TT: <br /> i hereby apply for the use of water in aceorc;mce with the rulex and rego- <br /> lationn ot the Water Department, for pnrposen and fisturcx eleted bclow. <br /> During the time that anq ot Lhe water mainc may be taken up by reeeon � <br /> nf nny improvementa authorized by Lhe City of Eeere!t, in or of any streeL or <br /> alley in a•hich they mxq have been laid, the City will not bc required to furnieh <br /> wnter during the progresa of euch improvements to any conaumer whoee euPP�Y <br /> may thue be cut off, or be[1]iable for �ny damegcA Cor icx failure eo to do. <br /> APFlicetian No.............D..I._n_V.......... <br /> Block....._�.�'.. .�i�. ..... ........ Lot...:�.V..'�.�...'..3.2. Add......................___.... <br /> __.... <br /> xo.........,.r..ca.......f.... . ._ ' � ................s:� <br /> _...__........... _................�.. <br /> ..........__._. .._ _......__.......... .... <br /> The work to be executed by........_.........__ .__._. ......Plumber <br /> ....._ `-_._. .._. ..... <br /> �S size of tap. <br /> ....._Tep to be inM�d in the mnin. , c d <br /> ............._.R'eter e1D�t •2Q i� /�l� �' d` <br /> // �.�- /. \ <br /> ........1.......Beth �� � � <br /> -...�'C--....lirinel <br /> �—��...Plein feucet inaide <br /> .-.-�......Side.a�elk washer <br /> -���:....Hoee bib ouleide � <br /> ......_--.-:�.Iioee bib for buildinQ pnrpoaes <br /> .......- ..—..Hoee bib ineide I � <br /> ......�--:....Bib for icenle containing....................etall.............. <br /> } <br /> ...... <br /> .--...—:...Number of pereone in family <br /> ��_��......Numbet of roame In buildinq <br /> The premieee are to be oeed ae e_._. <br /> . . . .................... <br /> The owner of the premieee ie.................�___. <br /> N <br /> The ag�ent is.............................................. . _ .;., <br /> ................... _....................._.. /9t_�/1 a., � <br /> � , � <br /> Thie app]icntion, elthouqh eigned, ehell not be binding upon the ity, nnt�l � <br /> aecepted by the 5uperintend�en�t 1af the ater Depertment. <br /> Si6ned........_�.•,L✓-d... ............ ....L',)_.. .. .. . ........ . ....APPlicant <br /> AccePted./..� ./�._-Z�--.....192...... Y._4//R�y`��..................._. <br /> _.' �Superinteudent <br />