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8z :�':.::�/.f-�)-N�-L. � ._�.v_.i.k+--o� �_ —"- 'i�� lii,Z <br /> �r. .. ` . . _ ' <br /> R'.U.}urm 1�-1uo0—E.3'.Co.-6-2G24 <br /> City of Everett•--�Water Department <br /> - � � <br /> APPLICATION FOI� WATER <br /> All binnks mu=t be filled in oF crossed out _ <br /> � <br /> E�•eret t...........��/{Y......................_........_............192.,?.^ <br /> YO Tili; SliPERIYTPNDENT OR THE II�AT��:R llCPARTilIPNT: <br /> CITY OR liV�I2ETT: <br /> I hereby npply Lor thr use oC wnter in accord:wce wiQi the rules nnd regu- <br /> Iati�ns oP lhc R'ater Depnrtroent, for pmpnses and fixtures etutcJ Uelow. <br /> lluring the time that nny of thc �rater mnins mny be tnken in 6y renson <br /> oi nn}� improvements anthorized Ay thc City ni livcrett, in or of m�y street or <br /> u�ley in �vLich thcy maq hncc Uc�n loid, thc City will not be required to furnish <br /> wnter dm•ing the Progress of such im�ira��ements to eny consumer whose supply <br /> may thus be cut ofC, ocr/bc'llinble for any dnmagec for its fnilure so to do. <br /> Applirntinn No.....Q..�.7.... .. ..... ,�„�' <br /> ......... .. <br /> _: I , <br /> Dlock.....r../...........i..��y..�.�z....__.. /I.ot...... _...D . . . Add................:.!_..;�..ti.L...... <br /> No...�..D...o`�.,5....../..I.U.`.1........ . :L�.-...._$treet <br /> __...__......... ........._.................................._.._.........__.............___............................................ <br /> Tlic work to be executed by..._.._.... .. . '�....._......__......._...........Plumber <br /> State size of tap. ,j/�- �(/'�' � " a �?� � <br /> �Z:.....TaP Lo bc inscrted in thc mnin. "- f��` }'�-� <br /> ...�..._..._.��'atm• claset / <br /> ...(...........Bnth <br /> ...L.:.....Urinal <br /> .._�..:......Plnin fnucet inside <br /> .....�::.....Side watk �vashcr <br /> ....(...........Hose bib outsidc ,--.; <br /> " � <br /> ...�.:.r......Aose bib for building purposes /�' <br /> ...L:......Hose biU insidc �/ <br /> ..L.:.......Bib for stnLlc containing....................stall.................... <br /> ......`......Numbcr of persons in fnmily <br /> ..l.........Number of rooms in building <br /> T ie premise= ure to be used as n._..__. ....___._.._.... . ._.._.... . .. .. . <br /> . .......... <br /> The owner oi the pnmises is...�._.....� � . . . .......................... <br /> Theegent is.................................... ................................................................................ <br /> T���s npplicntion, nl8iough signed, shnll not be biuding upmt the City, tmtil <br /> i by Lhe Svperintendent of the \\'ntcr Depnrtment. <br /> Signed.�...... -L��...����'�t��,..... pplicant <br /> ............ ......... <br /> , <br /> .'>_ _ <br /> ...� r�--'�192...... By.... -: - <br /> ............. ��.� � . .. ............... � <br /> _ ,,_�pperintendent <br /> l • <br />