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t� <br /> � <br /> � <br /> ' 1 � _}-- <br /> bl .s�.;...4-o=��-x�-�- '� -a-r�.l.Et .`J' -'bv - v';, f1�,�,� <br /> w.n.ra�m�-�roo-s.ec�.-s-es-z� � <br /> City of Everett��7ater Department <br /> APPLICATION FOR WATER <br /> All Ulnnks must Ue filled in or crossed out <br /> -: � � �� , t .. <br /> � Cecrett...........:...-.:.�.�.���::..:.......:.....................1D2.�<.. <br /> YO '1'IlP SUPEI2INTiA'DENT OP Tllti 1PATER DEPAI�,T\iENT: <br /> CITY OP �VEI2GTT; <br /> I I��ereby app1Y for tlie use of���nter in nceerdanee with the rtiles aud iegu- <br /> Intions of thc Wntcr DepnrtmenL, for purpuses nnd tisiures stnted below. <br /> During the lime that nny of thc wnter mnins mn}' hc tuken up by renson <br /> of nnS im�rovements nutharizrd by the Citp o: F.cetttt, in or of nny sLreet or <br /> ulley ir w�ich they may hnce been Inid, the Citg �eill not bc required to furnish <br /> n•nter during the progress ut eu:h impmvements to nny con:umer wlioae supply <br /> may U�us Le cut off, or be liaL'l.e/for any dmm�ges tor i�s fnilure so Lo do. <br /> Applicnlian No....��..�..7............... - <br /> IIlock....................................... Lot...._.................._.............. Add�m_�,.�,-•S,�l_(:.,f 1 <br /> No.......�U...a.5.........�..fl_c.�.........................Strcet <br /> ....._. .__.........._............................._................._..__._..................__... ...__. _._...._............... <br /> Thc work lo hc exccuted by....__.._. .__... �. . .G _. ._ . . ._. _.....PhunUcr <br /> ii,� �,5��— <br /> Stnlc size ot tnp. � <br /> ...�Z:......Tnp ta be inserted in the m��in. � <br /> ........ .....�Pntcr closet <br /> ....... :.....BntU <br /> � ....._'.-.:..Urinnl ' <br /> .....2:.....Plnin fnucet insidc <br /> �....Side �enll: �vasher � . <br /> ....../.........Ilose bib �utside <br /> .._....".-....Hose biU for building purpnses � <br /> ..........`......FIase bib inside <br /> ......_.`...:...Bib for stnble conlaiuing...................sWll................... <br /> ..._.....`.-.Number of persons in family <br /> ...��.....Number of rooma in Luilding � <br /> - ��nremiics nre to be used ns r...... ... ... (. . G(..Cr!-s-:��.-y`'�.._........... <br /> "' , �.:mer of tl�e Premises is....�t..._ .\...G(..� .'�0..".0..'L.................... <br /> '' �gent is................................................................._� ..�...../.............................._........ <br /> pplicntion, ulthougL signed, ,hnll not be binding upon lhe City, until <br /> y qie SuperintenJcnt ut tic A�ntcrAepnrtm t. <br /> � <br /> , Signed f�...............c.'.�f..........U.�..../�✓^✓'�/��7,j.a�-PiLH..A�i;lic¢nj�/ <br /> / J' ���. <br /> � <br /> - ,�_'S."Z.�.r.�2:S."102.._.. B�_.. . � ..................._/ <br /> �°�� uperintcadent <br />