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ru ' �-)�• ... ...�:�-+.w� n. , . . I'nui <br /> N'.U.Form d—IS00--ti.P.Co.—G--G-21 - <br /> City of Everett�--Watei� Department <br /> APPLICAT�ON FOR WATER <br /> All blanks must Ue filled in or crossed out <br /> Pvcrclt................._.... .../�.�._........_.._............192.�{. . <br /> r0 THG SUYliRiNTGNDG\T OP Tlli's R'.ATCR DEPAI2TilItiN'C: <br /> CITY OF EVEI:GT1': <br /> I Lere6p np�ity tor the usc ot water in accordance with thc rules nnd regu- <br /> Intions of the {��atcr Dupnrtmenl, inr purPoses and fix•.m•c, stnted Lclow. <br /> During thc time th��t nr.y of the �va�er mains mn1' Le. lnAcn uP UY icason <br /> of anp improocmmils authorud Uy the Cily oC I:cerctt, in or of any streeL or <br /> ullcy in whi�h �hey may hace bcen Inid, lhc City n•ill no[ bc required to turnish <br /> �cntcr durir.g q•e progress of such improvemcnts to nny com:umer whose supply <br /> nc�p lhus be cut off, ur be 1in61e for anp dsmngcs for its f�iilure so to do. <br /> Applicntion Ao. - ��.9� . . : <br /> . <br /> � � '•. r <br /> 61oc6...... ... .. . .. ����. Lo//tJJ.. /i� i.:�'..�.�.+ �� __.�.:. Add.._...._ . _. . ..__ .. .... <br /> No.. .�.�ri'.O � ,_/�.-tl--�-I'�/�-C.<K.Kr�.,Street <br /> _.... <br /> 0 <br /> __.__._..__.... __.._...._..__....._.:....................._..........................___. _... ._......................_... <br /> The �vork to bc execuled bY... .. ...... ....._. ._..._. . __. .. _._ _. .... . .. . ....PlumLer <br /> State sizc of tnp. <br /> �� .. <br /> r,.:....._....Tnp to 6e inserted in lhe mnin. . <br /> ....�..........R'alcr closet �� �`? � <br /> ...�....--.._.Un[h 'I7. <br /> ....—.........Urinnl <br /> ......-.-::.-...Plnin f�mcet insidc <br /> ......:..:...._Sidc �cnik washer <br /> .. .._�".�..flo=e bib outsidc <br /> ._.._-......I�Iosc bib for building purposes � � <br /> .....::.........fIose bib inside <br /> ..�..._.....Bib for stuUle coutnining........._.........stall_........_........ <br /> ..... ..._....Numbcr o[ persons in fnmily <br /> ................Numbcr o[ roams in building q. � <br /> The premises nrc to bc used ns n...... __�.-l.-i f,..�.�c..t.C_� .yj._.............. <br /> The oa•ner of Uie premises is...�--�...-.�—�...._¢-:c.7:.a..�.�.�:...�.�t.:C;�..c,.Lo--.-e <br /> Thcugent is................................._.._....__.. ..__.............................................................. <br /> This npplication, nithough signed, shall not bc Uinding upon lhc City, until <br /> accepted by lhe SUperintendcnt of lhe Nnter Depnrtment. <br /> Signed.........1..1v-:7c!..cP..R1.'G��!-"-..!....Y..c�C.�'�c_.<5....e-�.`.ApjJi icant / • <br /> �� / �::��� f... , <br /> elcceptCd.�.'ro_r. ......��... _ � <br /> a <br /> �r� S-._.._192...... IIy. i9 . . _.rll � ..._.................. .......... <br /> � � Superintendent <br />