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a <br /> .�i+��xi¢ .f:�y.r-L <br /> , '��-�;S,a�.� _ �j_ 'y3— i� I�•ii"� <br /> \Y.O.Form 1._Ip���l—E.P.Cu.-6-ZG.21 � . <br /> C'ity of Everett�--Water Depai•tment <br /> APPLICATION FOR VfATER <br /> All blanks must bo filled in or crnssed out <br /> E�•erett�.......... . . ..oZ.��..5_-..... .....1�J2...... <br /> � ................ <br /> PO TFIE SUPERINTENDENT OF THE A1'ER DGPARTnI�NT: <br /> CITY OF �VEItCTT; <br /> I hereby apply for the use of wnter in accordance with the �vles and regu- <br /> Intions ot the R'nter Dc ortment, for pm•poses and fixtures sti�ted below. <br /> Duriug Lhe time tRet m�y of the water mnins may be tuken up by reason <br /> of nny imprn��ements euthorized by the Cit,v of Everclt, in or of nny street or <br /> nliey in �vl�ich Ihey m:iy haee been Inid, the City �eil1 not be rnquired to furnish <br /> watur du:ing the progress of such improaements to any rnnsumer whose supply <br /> may th��. be cut ofi, or be linble fnr nny damnges for itx inilure so to do. <br /> APPlicntion No._....�r3..�'.�. <br /> .................. <br /> 131uck......�c�....�.J........... . Lot......._3� . Add.....................�..._. <br /> �f� /�. . .................... . <br /> .. . ............... <br /> No....../�.�..a......G..'.....y�F.c�.r..+...�..:...............Street <br /> / ... <br /> ....................................................................................... ..................................... <br /> Thc work to be exccuted by............ .__�..�c..�--.�--�,plumber <br /> Slnte aixe of tap. � � <br /> .-��........Tnp tn fir inserted in e mn' � �� r^ <br /> ..-..�.........Wnter closet <br /> ....(..........IInt h � <br /> ....C.........Urin al <br /> ...�........Plnin taucet inside <br /> ����-�.......Side wn1A �eashcr � <br /> .....L.........Hose bib outsidc <br /> ...�.........I�ose 6ib for Uuilding purposes <br /> ....�'�.......Hose bib insidc <br /> ..._�......Bib tor stnLlc contnining....................stnll....._.........._. <br /> �.............Number of pm•sons in fnmily <br /> �����.....Numbcr oY rooms in building <br /> The premiaes arc to be used as u.._..._ G�.��_,��_ <br /> .._....... .. ........ . . <br /> � ..... ......... . <br /> y� ... <br /> �he owncr of the premises is.......�... � <br /> (J'r.__. . . .. .. G....L.. . ,�.�� <br /> - •• agent is...................................................................................................................... <br /> apP��ention, although signed, shnll noTbe binding upon ihe City, until <br /> � by the Simrrintrndnnt .,( �ti� ixr <br /> / �� ..,..�,.�.�..���.;ui. n <br /> Signed . .�1:71,1UL.:...� �.._`—u:t}.�✓Y.L.. �f/� <br /> ........ ........ /�PPlicnnt j <br /> � ......... <br /> ,. ��.�— .l— �'���/.. . <br /> ......... .......'.��...... By.... ,,. _ . <br /> � / <br /> � �..��'j.���� �,�,`�,,�:��....................I <br /> `�� " d ._,-r.`_rintendent <br /> - /'! <br />