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e ..,-� �-��r-as-�N <br />W. D. !'urm A � -i' ^0—E.ltCo.-6�2G�Y� <br />G..i � /�G.-zc=?�% <br />,. _ <br />City of Everett�Water De;�artment <br />APPLICATION FOR WATER <br />All Ulank� must Lc filled in or crussed out <br />i/� / <br />c�„��tt .....................................................__.. ...i�i. � <br />TO TIIli SUPERINTENDGNT OF THI: \1'ATF:R DI3PARTDILNT: <br />CITY OR PVEIiETT: <br />I hercUy npply for tne use oC wnler in accurdnnce �cith the rules and regu- <br />Intions o[ the R'ntcr llePm�tment, for pw�puses nnJ ficm�es stnled below. <br />lluring thc time tli��t nny of lUc w:der mains may be l��l:cn up Uy renson <br />of nny� improvemenLs authorized by thc City o[ P•.ccrett, in ur of any s6reet or <br />ulley in mhieh thep may havc Lecn laid, tlro City will not be rnquired lo furnish <br />w;der during the prugress ot such improcetnents to nny ennsumer �vhose suPP�Y <br />may thus bc cut oCf, or Ue liable for uny damnges for its fnilure so lo do. <br />Block........s.�..5{........ Lot.._� . <br />Aliplicntion No ..................................._.... /� p <br />� ._..�.......__.....__._....._Str edd..Y Sic.c�/z.Za..o._.3. <br />No........_�.5...•2: �......._. ..�.. � <br />.... ...... .... _.__. _ _...... ....... <br />Thc wurk to bc executed b5 ..__. U�2yez.i_..A� ._. _._Plurober <br />Slnte size uf tnp. . <br />�..: �.......Tnp to be inscrted in thc mnin. <br />................\Vntcr closet <br />................ B n t h <br />• e <br />................Urmnl o = <br />. I� O i <br />................Plnin faucet iusidc <br />............. Sidc �e:ilk �cnslicr � <br />� � �� , <br />................I�Iosc bi6 outside � <br />i� , <br />................IIose Uiltfor Luilding purposea � LU. n•��r5 . <br />..............Ilose bib inside L� <br />................Bib for stnLle contnining...................stall.................... <br />.._.__.......Number of persons in fnmily <br />................NumUcr of raam� in bu�ildin� - n <br />The premises nre to be used ns a./`�-�---y�Xt;...._ ..._ ..... ...._..._ __.......... <br />The o�ener of the premises is ............._ _<<�. <br />. _.........._._ ........................_.._................ <br />Thengent is ...................................................................................................................... <br />This npplicntion, nithouqh signed, ahnll not be binding upon the CiLy, until <br />nccepted Uy the Superin/te-n�den�t o�f lh�e7 Nnyte�r Depnrtment. <br />Si„ �ed.... ..�y:.....Y.__�...(.c...._.f<.�/...!�4�0_..Pil/�/, �..........Ayplican � <br />/ /� i) � � <br />Accepted.....�:.lO_.-,.J�... ....192._... By.�v.re-��1�t. � . .... <br />� -y�$ crintendent <br />