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fira7.G.':e(/-v-.sf-„v:ao —4. �� ll �(�.: '"l.j ��d'y'r`/ <br /> . � _ � u�..J.I,.L.t_.( 1 <br /> \l�.U.Porm 1-.1500—?:.CCu.—G-:G-2a • ~ , <br /> C'ity of Everett�--�Uatei� Department <br /> APPLICATION FOR W�.TER <br /> All blanks nmst be filled in or crossed out <br /> i ^ <br /> Gverett,...........�...'�. ...1"}ti.�./ F...�?..�? ....1D2...... <br /> ...... ........... <br /> �,,,,,,, 1'0 THP SUPERINTGNllliNT 01` Tlili {PATF.12 llF.PABTDIfsNT: <br /> , C1TY OF I:VCI;ETT: . <br /> . I 1rercUy npply for the use of�v;der in accord:.nce «�ith qic rules nnd regu- ' <br /> � . 1¢tic,�s of lhc 11'ater Dcpartment, for purposes �md fixtures stated bclow. <br /> Dm�ing lhe time Lhnt nny of die �ccter mnins mny be lnken up Uy renson <br /> o[ nny impru��cments nuU�orized by the City oC Pcerett, in or ot m�y strcel m• , <br /> nlley in a�hich thcy ma}• linec bcen laid, thc City will nnt be required to furnish <br /> witer dm�ing thu pro{;ress of such improcements to nny cansumm� whose svpply <br /> m:�y thus be r�ri nff, or bc liuble for any dam.�ges for its tnilure so to do. <br /> Applicntinn No..��..� .... . <br /> ... ......_...... <br /> Block............................... .. . Lot. ' ., ' ' <br /> . . .. . . .......... .. Add.�.:�..-..�._.�......._...._...�._.'..�. <br /> A'o.....1.7...`�. ._�....�ct_ty��,.t..c....<..�Street � \ <br /> I <br /> _..._._.... ........__......_.........__.................._. ...........__......... <br /> __........ -- � <br /> \ <br /> The �vork to be esecutecl bY...__._.......__.. ........ .. _. ..............._'.:].�.....PlLmber � <br /> —_Jv - Ci <br /> Slnlc sizc of tnp. / !c- ����' \ <br /> ..�2...._Tnp to bc inserted in LLe mnin. <br /> \\ <br /> ...c.........Nntcr closet '� <br /> ..._�.....Bath �...,\ , <br /> .... �:.....Urinnl � �': - . <br /> ..._�........_Plain fnucet in�ide � .. �`, <br /> .....L......Side wnik �cnslicr . ���. <br /> ....�..........Hose bib o�Lsido . <br /> ....`..-.....I�osc Lib for building pm•poses � <br /> __G.......ilose UiU inside <br /> ....G..._...IIib for staLlc containing....................stnll......_....._..... ': <br /> ....�......Numbcr of persons in fnmily �, <br /> .... ..5.._...Number of rooms in building �/� "`�� . <br /> The Premises arc to be used ns a....... ....�'..`.:1,.�tJJ,..L-GL,t�!.�c-�__._... �, <br /> :ka o«�ncr of the premises is.....__...._......_......_.._._._.................._.............._......... �'..�� <br /> aP.ent is..............._................................................__....._....................._................... �`, <br /> •;plication, allh�ufih signed, ,hnll not be binding upon the City, until � <br /> ' lhe Superintcy�l; 6 of the Nnter Depnrtmrnt. �`, <br /> �/ /� / � ��/ <br /> ",ignedJ�....�... sLF�l.�.�..*.f..�........{Jft-O'l��L.Lt..��.�i . pplicnnt <br /> 1 ! / `, , <br /> «;....-GI......��5=.iaz...... ny.�. .,..�-���/'...`. /............................ <br /> / �'� iL�uperintendent <br /> L " ' /_.���16'��� <br /> rr <br />