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�i'.xJ'C <br />�Y V <br />RS D. Fonn G—IL00—E1'.Co.—G-:G•2d <br />-.,-�-1�.� ._�Q � - I `� - �•1 �"� � <br />City of Everett�Wate�� Departmen� <br />APPLICATION. Fi�R WATER <br />All blanks tnust Ue fillr.d in or crossc� out <br />i <br />Gverett..... .. . ..C�. ....,..�, ......................................lOS }.. <br />TO TIIE SUPERINT�NDIiNT OR TIIi3 \V. �R DEPAI2'PIIGNT: <br />CITY U(' ti � TT: <br />I hereby npply for the us�� of t�•ater in nccm•dance �vith the rules und regu- <br />1¢tians r: the R'irier Depnrt�acnt, for purpo=es nnd fixtur^s stated Uelow. <br />During the lime thnt nny of thc «•nler mnins mny be tnken up Ly renson <br />of any improvements nuthorized by the Cit}• of Pvcrett, in or of nny sLreeL or <br />nllc in which they mny hn�•c Ucen Inid, lhe City will not be requimd to furnish <br />a'ater during the progress uf such imprrverocnts to any cmisumer whose supply <br />may thus 6e cut of[, oQr/ ye linblre/fur ai�y dnmuges for its fnilure so to do. <br />Application No....jj..�_� '. . ` . <br />....I ................ <br />,, . <br />Block ....................�!............... Lot......:.::::.:�u.:' Add..._...........:......................... <br />/�..... ....... . <br />No....�7. �l.��i(,/1.�..�t4K_.._.Strcet <br />�` <br />....._...._...___ ..............................................._...._................. ......... ..................................... <br />The �em�k to be executed by..._.�/2..G—C�(.�'.. �--,.G..�......._.....Ylumber <br />State sizc of tnp. .1 �����f�= <br />.._l,y.......Tnp ta be i��scrted in thc mnin. <br />.....�........�{'nter doset <br />...(..........Bath <br />.....�......Urinnl <br />....�........Plnin faucet insidc <br />..._...`....:...Side «•nik o�nshcr <br />.....�.........Hose biU oulsidc <br />..._r.........Hose bib for Uuilding purposes <br />vV <br />.......`.........Iiose bi5 inside <br />.....5........Bib for stnble contnining ....................stall.................... <br />....._�.......Numbcr of persons in fnmily <br />.../.......Numbcr of rooms in building <br />Tlie premises are to Uc used as �.�. ... ..... .__ ................_.... .... <br />Thc o�vncr of the prernises is..._f .. .e......... .yJ../!i1 � <br />........... <br />� .................. <br />Thcagent is ...................................................................................................................... <br />This nppticnnon, ulthough signed, ahnll not 6e binding upon thc Cit�, until <br />nccepted by ilie Superi:a fde�rt of the 1Vnter Depnrhnent. , <br />/ �7 ) <br />Signed.�..� .�..�'(.L�.G.L...C�'..�.,::.../6..;�� ...� _..Appliwnt <br />A^cepted, ��. _-/G%.-.�✓..:192._.. BY...../L ...�`�]:��..� ............................... [ <br />� .:�'; ��� `--'�SuperintendenE � <br />