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�.. .-... .. , �. .. �. .tv 1.�1 >^ /Y^n.-n . . <br />H'. D. Form 4-Ib00—E.P.I'q—G-26�2� <br />City of Everett�--Water Depariment <br />APPLICATION FOR �TATER <br />All blanks must Le iilled in or crossed out � <br />i <br />. �)�j l <br />��•crett. ................./....!/...Clj.G�... �,%................192.�.0 <br />TO TI1E SUl'ERINTENDENT OF THE R'ATF.R UEFARTniE"T: <br />CITY OF EVPI2CTT: <br />I hereLy npp!}• for the use of a•ater in ;iccord;mce tcith the ruies nnd regu- <br />intions ot the Nnter Department, for pmposes nnd tis'ures stated bcic�c. <br />During the time thnt miy ot thc �rater mnins may be lnken up Ly rmson <br />o[ nny improvements nuthorized by the City o[ Liccrett, in or of viy sLrect or <br />allcy in �vl�ich they mny hnve been lnid, the City �vill not bc rnquired to furnish <br />«:.tcr during the progress of such im, roacments lo any cnnsumcr �vhuse supply <br />may thus be cut uff, ot be liu,bl/e for any damnges for its fnilure so to do. <br />q ��N <br />Applicution No .............�..T................. � <br />Block ................._�.�.�'.._.. . ot.........l...l...... _ . Add....._......_....... <br />7 F ,/� // . .. _...... . . .. <br />No........�v...U..��..z..........(1-�'l....... l�.4Street <br />_. ....._ ............................................. .. .......................�............... __.... <br />The �vork to be executed by.........._ L[!L�%.G/_ ....................Plumber <br />Stnle size of tnP. 1�/ �jJ/'Q �—`-. �e�.h..-G(%3�,/�. <br />�l� 0 y <br />........_Tap to be inserted in the mnin. <br />._ .............��'nter closet <br />................ R ¢ t h � <br />/ j <br />................Urinal . . . , <br />................Plnin fnucet inside / � <br />................Side wnik tvnshcr � � <br />.__...........Hose bib oatsidc <br />...............IIose Uib for building purpcses <br />................FIose bib insidc <br />................Bib for staUle conlnining....................stall.................... <br />................A'umber of persons in fumily <br />................Numbcr of rooms in buildiug <br />The premises arc to be used as a.. � ........... <br />...._._........ .._ ........... .._ ._�..7.... <br />Thr. owncr of the premises i� �"..Zf:!w,Z�lN�.�.rc� <br />Tha agent is.......... .. d.Lc.!1.Q�� ......................_�............ ...- _ <br />This npplicntion, sltho �h �signed, shnll not be 6inding upon t}:e City, until <br />:eepted by the Superintendent of the Nnter Depnrtment. , <br />lceepted.�.:.` ........-...1S�1/ <br />� —. <br />