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2-r.i.c.. <L 1 - � _ <br />;- �- � � - , � , t-,-`1..A��-h._ � � � � . - 1 i%: <br />_ i <br />R'. 0. Fnrm J—IG00--F..P.Co.—G-:6�:1 <br />City of Everett�Water Depai�tinent <br />APPLICATION FOR WATER <br />All bl:mlcs must be filled in or crossed out <br />Everett�.........._�/L��. �...... ..... �_.C,........__......1�2./.. <br />TO TIiP SUPli2INTIiNUF.NT OR TI?5 \\'ATC;R Qi�PART:lIliN9': � <br />C1T1 OF E`,�EBtiTT: <br />I lierehp apply Cor the use cf w:LLer in accr,rd:mee with Uie rules und regu- <br />lations of the R'ntcr Depnrtment, tor pmp�ues �md fi�:tures statrd Uclo�e. <br />Ilering Uie limc that nny ot the �eater ronins mny be tnken up Uy rea=on <br />of tin�� improven:ants aulhnrized Uy the City o[ EcerutL, in or ot �my stroct or <br />alley in �rhich ;hcy may hnee Lcen Inid, the City �eill not be required to furnieh <br />�vater during the progress of such improvemenl� Lo nny consumer �chose supply <br />may lhus- Uc cuL uf[, por' /b�e pL'aLle fm• any damnge.a tur its f.iilure su to do. <br />Aptilicntion No... p../7..0.�........ — I(�- I <br />r 7 <br />Block ..... Lr, .-��.... . Lot... ... �... .. . .... Add. __ ... _ . __ __.. .... <br />xo. ..a.� �_l __.�%%1.�,�i�-�,�.st ��t <br />/ � <br />_........___ ........................._._................. ..._ ..._.. .._ . _ _ ..__..... __... <br />�� � <br />Thc work to be esewted by_.. .. _�C.yt�-e• �L._.__...._Plurober <br />/� . <br />Stat size of tnp. <br />,��..Tnp to be inserted in the mnin. <br />..._.�.......R'ntcr closet <br />/.........u1cn F=. -.�. <br />......_r ..Urinnl C.� •'� � <br />__.�r..-._Plain fnucet inside <br />._...-...—..Sidc �calk �rnsLer <br />__..�.........Ilose bib outsidc <br />..... ... _Hose biL for Uuil:ling pm�posrs <br />-- <br />.__......_...Hose bib insidc <br />......._ ..Uib for stnUle contnining........_..........slnll._........_...._. <br />....�.A'umbcr ot persons ir fnmily <br />. ly...... NumUcr o[ room., in building �. <br />1'he p�emisex nrc to Uc used ns a . . - .. <br />. ... ... . ...... ... <br />'�c owncr of thc �iremises is �,,.G.ri�.'.. �.. l�rt/1.���s�.._._..... <br />1 <br />agrntis ......................................._............. . .._.._......_............_............................. <br />. npplicntion, n1U�ough signed, shnll iot Ue Uindiug upon the City, until <br />�! b�� lhe Superintenduit of the R�nter Dep:irlment. <br />Signed�/..�1�.�.t�..... . . . .._ .. �� .. A licnnt <br />......... .... <br />�.._. . : - . . . <br />AccepteJ._....�..r....�....._......19E`_ By._.�!!19!�./..•. � <br />. . . .......... <br />� � endent <br />