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�..-�r �,,,-s-�--�; <br />N. A, Fonn i-, IL00—E.P.Co.—L-:G :C <br />F_-.�TA s—�' z� t�' <br />City of Everett�Wnter Depai�tment <br />APPLICATION FOR WATER <br />All Ulanlcs must bc filled in or crossed out <br />F,Ycrett ..................:...�./C ...... .... .�. �..�.................102.� <br />TO TSIP SUPERINTCNULNT OF TiiP \VATI:I2 NtT3fENT: <br />CPPY OI� EVCI2ETT; <br />I hereUy npply far the use of �c�ter in accardance with the rules nnd regu- <br />lations of Us Nnter Depnrtment, far purpo,es nnd fistvres statccl below. <br />Dw•ing the time tlmt n»g oC thc «'ater mnins m^V be tnken up 63' renson <br />ot nny improacments authoriud Uy the City ot C�rre.c, in or of nny alrcet or <br />nllcy in }eLich they mny hnce been lnid, tl�e City ��•ill not Ue mquired lo furnish <br />�vater during �.lie progress of such improvements to nny consumer whoue supP�Y <br />m:iy thus Ue ruL ott, o be I/in/Ule for mq� dnnwgcs fur, 1its fnilure co lo Qo. <br />Applicntinnr/ 1��p0...�.�..T...�........... ' /� . . � <br />Bloc6 .. ..� d..G..... ...... Lot...... . � _.... Add.... ...... �..:.�'.'' <br />.. .. <br />No . .. y�.l%.. ��C`/�'�:�-G..Strcet � <br />✓ <br />'Phe work to be executeJ Up....... _ ............. .. __.._......................Plumber <br />/`..�� 6.... ., <br />Siatc size of tnp. •� , <br />.« ater closet � ��, ' <br />i' <br />..�Z::....Tnp to b� inserted in lhu mnin. �.��� ^ �i i <br />�_._` ... i 'I .. ' `' .�+...�. <br />.. i <br />.....-........E-'h � � � /"�k(tn �-��1 <br />.....c�.:.......Jrinnl �� ` ,/ _. . <br />......�:......Plain fnuceL inside ....._ ....�� � � � <br />................Side �ealk «�ashcr <br />........L......IIosc bib ouL�ide <br />.....:.. .....Hosc bib for building purposes <br />................Hose bib insidc <br />................IIib for sLnUlc cunlninin�....................stall.................... <br />..........._...A'umbcr of persons in family <br />....�::...._Tumber of rooms in building <br />Tlm premises are to be used ns n..... .._....., l�i.__J�.,_.._.._. <br />... . . .. <br />��........... ... <br />The owner of U�e Premises is...... �:�.l�..G.f.......1(.� ..._ ..,,.. _ i�......_ _..... <br />Thcagent is ................................................._.......................................... � . <br />........ _ ............... <br />This npplication, although signed, ,Lnll not be binding upon the City, until <br />acceptr.d by tLe Superinten�dcnt /Jo[ ih 1Vnt:,r De mrtment. <br />Signed..��.... .L� l�if....�!/1.-&?�.1� ................ .. / Applicnnt <br />Aceepted.�..r'�_/..e'z.....-..........];12.5�� By.... ��- <br />�� . ...:........................... <br />-��-�SuPerintendent <br />,� <br />"'�fY- 1 <br />., . ..�r�. � <br />' s�� - <br />