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� ��-�- '�-c,- fj� , ��,�����<� `� - I `1 �l,U (3-h.� <br /> \V.D.Porm 4—ISOV—E.S'.Co:-6.26-:4 <br /> City of Everett�Wnter Department <br /> APPLICATION FOR WATER <br /> All bl:mlcs umst t�e filled in or crossed out <br /> / <br /> Evcrett,,..�� .��'��...--..�.�....................1D2.4. <br /> 1'0 TIiE SUYh:R1NTENDI3NT OF TIIP R'A iR DBPAlt9'nfGNT: <br /> CITY OF �VERCTT: <br /> I hereby a�pply for the nae of���ater in accord:mce �vitl� thc rcics nnd regu- <br /> lations of the Nater Depnrtment, for pmposea nnd fix:ures stuted below. <br /> During the timc th¢t m�y of the �vnter mnins mny 6e tnken up by renson <br /> o[ nny improvements nuthorized Uy tlw City of Eccrett, in or of nny strcet or � <br /> alley in whieh Iheg may hnce Ucen Inid, thc City will not bc required to furnish <br /> �rnter durinF lhe progress at such intprocements to nny ronsumer whase supply <br /> m:iy thus be cut otf, or bc linulc for nny damnges tor its fnilure so to do. <br /> �j.c- _ �__ �; . <br /> Applicntion No....0..✓...�................._ - � /U �1 - ' n—�-� -� <br /> Block........................._......_._ Lot............._............... .. Add�:�."'..�-�-�+.-+1.__. <br /> � V <br /> No...��.�Jr.........�_U.��............_............Stmet <br /> .. ..._......_.._............................................................. <br /> ................... ...... . . ... ... <br /> . . .._......................... <br /> The �vork to be executed bY.............�. G._ . .... _._..__.........._...._..PlumUer � <br /> Sl�te sizc of tap. / /-'0 U � <br /> ✓ <br /> ...._._�c.Tnp to bc inscrt^d in tlm mnin. <br /> _...../....._W¢ler doset <br /> .......1......IIath <br /> ........-.-:...Urin al <br /> .......?....Plnin fnucet insidc <br /> .._.._.. ...Sidc wnik «�nsher / <br /> ....._!_.....Iiosc hib oulside ' /� <br /> .........-.'...Hose bib for Luilding purposes i <br /> .........—...Hose bib inside <br /> ......_—:...Bib for stnUle mntnining....._.............stnll......._........... <br /> ........-....A'umber of peraons in fnmily <br /> ._... .. Numbcr of rooms in building <br /> ... <br /> The premisee nre to be used ns n............... ... !�...-....._.p._ .........r...... / <br /> The o�mer of the prrmisca is......�Q��Lf,,:�Ca.,.�_T.���L[,:c-` <br /> •�gent is......................... .... ............_.....__.................._._..._................................... <br /> . �; npplic::tion, although si�;ned, shiill not Lc binding uPon the City, until <br /> �. ' � Fy the :�uperinten ent of thc Natcr Depnrtment. <br /> SiEncl....................................................... ,.�r'�--EC,�..... . ..Ap lic n� <br /> �i� / <br /> � ................G�.....-/...r...192�r. II ..._...L.`-� . <br /> y . _ ... ... ... . . . <br /> / dent <br />