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. .. � .o � /- f S � 1�' iv"T�D �_1 �--7-� _ r J! <br /> ' ' . ." <br /> \V. p. Fcrm � I500 �-I-17 C.P. <br /> Cl7'Y OF EVERETTa=W'ater Department <br /> .Application for Water <br /> ,,, � . All blanks ntus[�� (Iled in ur aossed nut <br /> ,�:.e. :�� ..; '•. Eecmtt,__= / �__z'�___.___.19Y_.'�. <br /> . � � ��� 'f�' 'i I IE SUPIiRIN7'ENUEN'1'OF 7'Hl R'A7'IiR UI.PAI!TMBNT. <br /> . . � CI'1'1'OF Ii'/GNETT: <br /> � . � I hereby apply for the use nf�cater in acrnrdance ���ith ihe rule�aud reguln� <br /> n ei;of The \Vater Uepartm:nt. tor purposes :md fizlures s�ated belo�t. <br /> 1)urinG tL•e time Ihat anr n(the water mains may be taken up by renson o( <br /> any imPrnv��mcNa authorized hy Ihe Ci�p af Everrtt.in or ot :my sircet or alley in <br /> �chich tlirp m;iY have been laid, Um Ciry� will not be rcquired o Icrnieh w^.:-r durinF <br /> the progr�-=s of s�ch improvements to any consumer �ehoce a:�pply m:iy irus Ue cut <br /> off.ur 6c :iablc f ir nm damra/ges tor its (ailure sn ln do. <br /> Appli.nlinnlJu2."_ _"/ �./""'_ � . <br /> Blnck . .ci_d__ rt_�_� _ Add_`JNu"__.__. <br /> __ <br /> / �'____._. <br /> Nn._____�.�_.�- �..____"'_ . ",X-�-�=�Q�-.Street <br /> (� <br /> ' ___'_"___.'__" <br /> 'I'he�vnrk :obeexeculedb)'.___"_"_""".._._.__'__ ___._.____ Plum6er <br /> Stale sizr n( lap. <br /> t <br /> ____ _d-."1'ap to be insvrted in tlic niain. �� /� o G <br /> . , .__.1Vatcrdnsci � '' <br /> .__"___ 11atli <br /> .__.__ .Urinal <br /> . ________Plain faucet insidc <br /> _. ..______Sidc w�alk �exsLcr <br /> ____.__.._Hose biU uu�:�i�ie ^ <br /> _____. __Ilosebib (nrbuildin{;purpuses �� <br /> ______....Hosc biU insidc /.� , ' <br /> __"_'."'13ibforstaLlecuntaining_.__. _____sta]I__.___-..; . C � <br /> ._._.. .__Number of persuns in family <br /> ______'_"Nunil�•r of romns.in huilding <br /> Thep�emisesnmtobcuscdasa._'_...._ _ _ "_. ...__7_. .__._ ___. <br /> ij.�C . <br /> 'I'he owncr o(the prcmises is ___✓�"__�" � . <br /> . .. ._____.__ _. <br /> 1'hc ��Rcnli� .___'__________ _______________ ___ _ _' _.__.__"_'.___..____..__ <br /> 'i his applic:itiun,ahhouxh signed.sh��ll nui bc binJing upon thc City, unlil ao <br /> cepted by Thc Superimendent u(thc 1Ynter ll�rtment. <br /> Signed ___.11�__.�_t/!��,._ .�..___'_.Applirant <br /> • �-. i.. �i_ � ' "-^_'" <br /> Accepte<t_7_ .- .:�.____yyj'_.' Ity r ' <br /> ..,.. _-_ . __._. __s��:�n:n-�:.oi � /� <br /> t <br />