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� <br /> i <br /> i` <br />� <br /> 8r..rl/ 'wJ:J'j-�J'L. ��.Y�Y�.�V`�LV :��YJ — /J 1. '/✓ <br /> N'.D.Fbrm�—I600—F..P.Co.-6-2GR1 � <br /> City of Everett�Water Depnl'tment <br /> ;:..�,;.�s <br /> APPLIC�TI�ON FOR WATER <br /> All bl.mks must be filled in or crossed out <br /> L�����«,..........��!,/.�.:,/3�..............................i��._... <br /> TO TIiP SUPliRINTliNllIsNCITY OF EVl 2liTT;DrPARTnItiNT: <br /> I Lereby appiy for the use of�e�ter in acem•dance�citl� tUe rules nnd regu- <br /> Inliuns o[ the R�ater llepnrtment, far pm�pnses nnd fi�tures stated Uclow. <br /> Durinb the time thnt nn>' oC Llic �calcr m�ins mny Ue lnken aP �S' reason <br /> of nny improcements authoriud by the Citg ot Geerett, in or of nny �treet or <br /> nlley in �chich they mny hnee bcen lnid, thc City will no: bc rc�uired to furnish <br /> x•:iter durin6 �he P�'ogress of such improrements to nny consumer a�hose supplY <br /> ro:i}• thus 6e cut of[, o`r bc liable for :my damn6es for its fnilure su to do. <br /> Appliculion Nu.....l�l..�.�................_.. <br /> 131ock......./.......... p Lot........_. . Add��.:e'1���... <br /> .............../.�....,.�.. .... <br /> ................... <br /> ;Io....v�.(9..U.as......:./`/. . ..._._. ... ..................Street <br /> ._.._...__......................................._..........................._.................._.... ....._.._......................._. <br /> The work to Uc executed 6y.........._ . _... ... ..__...__......__...Plum6cr <br /> .._...._. ._.___. <br /> 5tele eizc of tnp. � <br /> /^y�-,.......Tnp to Uc inscrted in tlie mnin. <br /> / ...1...........\1'nter closct <br /> ._�............Bndi � . <br /> _�.........Urinal <br /> y:......:...Plnin fnucet insidc � <br /> � .Side �vnllc �vushcr ' <br /> ............... <br /> .�...........Hose bib oulside <br /> ...'`.:.-....._Hose bib for building purposes � ' r—;j � ��� <br /> ._`.-....iIose biL i�sidc ��•' ��� � ' <br /> .._...`.........l�ib for stnUle containing...................stall_.................. <br /> .../L�_........A'umbcr uf per:nna in familY ,,� i�' � :"' • -� �J" �� <br /> ..7..........NumUcr ot rooms in building � <br /> / <br /> The premises nrc to bc used as a.._."._.�..��/J �..� � �/-- �C�^--� <br /> The owncr of thc premises is..�,.GL,c.GGL«�<--�`��`��� <br /> ".:e ngent is......................................................_..._.....__..............................._............... <br /> � npplicatian, nithouB�� signed, shall not Ue Uinding upon thc City, until <br /> ��� hy lhe Superinte�n(d�cnt cf Um Natcr Depnrtment. <br /> Signed;v v(�.�. ����i...... ............_......AppL nt <br /> •.:� ��ted. ..�y_.,.?�-..__Zv`..192...... IIY........ .. . ..��� . A/ntendent... <br /> �.... <br /> .......... .. <br /> ?�. <br /> s ; <br />