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�C1—� //—/2 - 3/' /T `.�._ctf '/_ /5 - _1 if�. <br /> lV.f).Forro J—ISou—•L'P.Co,g.y�._� I � � � <br /> City of Everett�---Water :Department <br /> APPLICATION FOR WATER <br /> A11 blanks r.rost bc fitled in or crasned out <br /> Evcrett.............._y�. � . . ...... �..-��.... ............10?3.� <br /> TO TAE SUPERIN'PEIJDGNT OF 7'li R' RR DEPAftTIIIENT: <br /> CITT OF ItLTT: � <br /> I hercUy npply tor the use of water in nccardance with the rules mid reFu- <br /> Intions o: thc Watcr llcpartment, for purposes nnd fixtmrs stated below. <br /> During the timc th¢t any of the water muins mny be tnAcn up by renson <br /> of nny im irovements nutUorizcd by the City of E��crett, in or of nny strect or <br /> nlley in w�ich ihey may huve Ucen Inid, the City will nu4 be required to fcrnish <br /> �cntec during the progress af such improvements to uuy consumer whose supply <br /> mny tlms 6c cut off, or 6 /lia/blc��/'r any� daumges For its fnilure so to do. <br /> ApPlication No.....-�! �,/���.(l.............. — �? `� � � Y <br /> Rlock................��/ F' . Lot.................................... . Add..........� — <br /> 'r/.............. . — ............................. <br /> No......./�.�.y..�:..". . ............ treet <br /> ...._.__....................�-:�...(?_�..:i:...:S_l��� � <br /> ............................... .................................... <br /> Thc work to be e�ewted by....._................ .... umber <br /> ................................... <br /> Statp size of tnp. �y /..J��� ` , <br /> i�� � ,. -:.., ' <br /> f/Z...Tnp to be inserted in the mnin. ' !.�'��.�� ; � ? <br /> ........�......Nnter doset �... � �, I 1 „ ���1'�;'''��. . <br /> .......�_..._Bnth • r C C. �. . . . . <br /> �.1'-� '�� Y_aETT '. <br /> .......-.—.....Urinnl _. C <br /> .......�...Plnin fnucct insidc . �. ... .... . / <br /> ....-......—I Side walk wnsher l� � <br /> ...._..........Hose bib outside <br /> ........".....Hose bib for buihiing purposes <br /> ........".....Hose Uib inside <br /> ........'�.....Bib for stablc contnining...................stnll.................... <br /> .......�.....Number of persons in fumily <br /> .....�,....Number of ruums in Uuilding <br /> The premises nrc to be used ns n....... ..�/J� <br /> � .. . ..._......... . <br /> ' <br /> . _._............... <br /> The owner of the premises is......�� � p / <br /> /�-r... ....�-Gt�.�....�.. <br /> Thc ngent is.................__............(V... <br /> ............................1. .......................... <br /> ... .. <br /> ........... <br /> This npplication, nithough signed, shall not be bindin u on fhe City, until <br /> accepted by the Superint�^y d�ent of t e �1ntey-j�e tm g P <br /> Sigue�l...�J..!1��..A �': <br /> / .V.�-����� .. ....... ............... p ' nnt <br /> . _1.... .../., ...... �J� <br /> ,y A <br /> dccepted..� /�,jl 192..... B � . „F ��� <br /> / .� �. . ...�Ll;rl�.............. <br /> . �itendent <br />