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�-.+z.e sf-��-� o - �.v . .. y�.u..,_. ,. i - � r'� �� � . <br /> 7 <br /> N.U.Form 4-1cW—E.P.Co.—L:6�2i <br /> City of Everett•--Water Departm�nt <br /> APPLICATION FUR WATER <br /> All Ulnnl;s must be filled in or crossed ont <br /> livcrett,......_�j�.l.tlz..........�....._...............102.�.. <br /> TO 1'IIE SUPERINTBNUEN?' OF Tlli's l5'ATER DGI'ARTnitiA'T: <br /> CI1Y OF EVEI:ETT: <br /> 1 hercl>Y �PP�Y t��r the use of a�:iler in accordance a•ith the �vles nnJ regu- <br /> lations of the R'nter Departmmrt, tor pm�poses and ficures slntrd below. <br /> Dm ing the time thnt nny of thc �catcr mnins mny bc taken up by rensan <br /> of nny iniprocmnents nuthorized by Uie City of Ecerett, in ar of any sLreet or � <br /> ulley in which they may hnve been I:iid, the Cily �cill not be required to furnish <br /> a�ater dm•ing the progress ot such improcemaris to nny consumer whuse suPP�Y <br /> m:�y llmc Le cut uf[, or(�%u linble tur nny dmnages for its fnilure �a lo do. <br /> APPlicntion No.......Q....���._......._... <br /> Block ........ . Lot .... ' <br /> �. /� .n.._ . ......... AJd._ .._ .. .. __.. ._.._. _... <br /> No...� d�v. �..Q.'�l..S!`. ....._Sfreet <br /> ... . . .. .__... .._.........................._.._.__.......... ......... ......'.''7.�-._........ . . ...._.........._........... <br /> ...The work lo Lc esecuted Uy._.. .. .r�/y�(/�---��._....Plum6er <br /> Stnte sizc of tnp. �-�� " U �� , <br /> .\�'nter closct I / � / �. ; � � ` <br /> ....���-.Tn to Uc inserted in the mnin. �� ���.- '� � � �, 1 � <br /> ' '..i l l i ' . <br /> __..�....._ � �i _ . <br /> ,�.. ,�i �.{ '-AIE� � `. ; <br /> �u' ^ ._: <br /> �..._....Bnth 1.111' Oi GVERETj� ' <br /> — � � U;.�"( <br /> ......_........Urinnl G�:'. �- - <br /> ............(....:� <br /> ,�.......Plain fnucet inside ............... <br /> ...._..-.....Sidc �cnik �vn,hcr <br /> __...J.......Ilosc bib oulside <br /> ........_^......Hose 6ib for building purpu.s•�< <br /> __._..—_IIose biL insidc <br /> ........."..Bib for stnblc wntninin�....... ......__slall___._..___... <br /> ........-:...A'umbcr of persons in tamily <br /> ......y._A*umUer of romns in buildin� . .`�, <br /> � ,. <br /> Thc premises nre to Ue used ns a....__._. .. j-I-J�.. __._._........___..._.._...... <br /> ^b^ owm:r nf thc Prccii�es is.........._ . . __.._...._._.._. _. ...__.._.................... ........ <br /> .. .. , . .�gent is................_._......._. .........._ _..........__.. <br /> .._........._..............._......._............. <br /> �'�' -� � �rr���:�t���, although signed, shnll not l�e bindinR upon Qie City, until <br /> ,�.-�:� �'..�.�' r Lhe Suprrintcndcnt o[ thc \Vater D�pnrtmenl � <br /> � ri <br /> fiigned�,. !.._ � � .,....:.. � .. .. .:. 1��..�: :' . - - e�PPlicant <br /> 3 / � <br /> ArcC <br /> p' ... � .... 1�2(O. B} ..��s...�. . ... .... <br /> . . Superintendent <br />