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. . ,.. � . � ,.� ' p 3_.��" '7_. <br />.^� � . � <br />W. D. Farm 4 I500 3-1-17 C, P. <br />CI�'Y OF EVERETT==Water Department <br />Application for ��ater <br />All blanAs must be filled in or c ossed out <br />. � <br />qveretl._____ _'�_f.__`_�'/��..—_____.__19#�� <br />TO 'fHE SUPIiRINTGNDIiN'I' OP THI3 WATF.R DGPAKTb1GN'I'. <br />CI1'}' pF G7GI2ETT: <br />1 hereb)' �pply tnr tlic usc nf watcr in :¢cordnnre �eith Ihe mles and regula� <br />ti:ms uf The Nater Ueparum�nt. !nr purposcs aud fistures stated bdo�c. <br />Durin� the tin;e tl.at an}� ot the water mains mar be [aken up by rcason ut <br />auy improve�nenls authoriud 6y t'ne Citc �.! Evcrctt, in or of any strcet or alley in <br />which ther n�. �5' h:�ve becn laid. thc Ciq' will nn[ he. rcquired tn (umish water during <br />�he progress nt such improvemrnts tn any ennsumer n�hose suppW mar ihus be cut <br />nH, ur bc liable for an5' ��miK�s tor its iailure so tu do. <br />Applirntian No.""��,� _ _ _ _ _ _ _ _ _ <br />! v � <br />Black '__�`� � __' I "__" ' _' _"' Add'_"""_"'_"'_" <br />-'__ <br />— <br />\o. --- - � � `� / - —' --- - -----".. ... .. Slreet <br />_ . _'"' _"' _ _"'. """_ __"_' _ _"""_" . <br />'Phc wnrk Io bc r�ccuted by..____ ____'__" '_____'_____.____'______ Plumbcr <br />Staqlc /.y'zc nf tap. n ��� ����aQil� <br />. j-�"fap ty,6y"fisc���lcLLd in Uqqie maii 1� /� �/ <br />_______.__1V;iter�uset �-••� � ��,�<J�_.L <br />--..-----Bath � <br />---..___ .Urinal � � <br />-.-'______Plain faucetinsiAc �s s`9 <br />i <br />. --______Sidr walk �vashcr � � � -/ <br />._-___'_Huse 6iboutside �� � , 1�/� b�' <br />-___'___Ilose bib forbuilding purposes �77/ <br />. - . _ _ _ "_. I�iosc bIb i nsidc p'�1 <br />._"_'_"_lii6lorstahlecuntaining____.'__.._stall____ _._..�y�� ,J^ ��� <br />b S�` <br />..____'_Numbcrofpersunsinfamily 1 YY ry <br />. _. _. _ _ _'Nwnber u( rooms in huilding �„� <br />'Phepremisesare�o6cusedasa_.__'___""""_'._.._..'__"__"___ .__.. <br />'I'hc ownerotthepremisesis ____'.___.___._ ______________________.'___. <br />7'hc aF."ntis ..'_______ <br />'.___ .__.__.________.____'_______ <br />7'his applicalion, :�Iihough signcJ, shall nut be binding upnn thc CitY, unlil ao <br />cepted b}• Tho °nperinteudent u( th/7e 1 ntcr Uep:�rtmenl. <br />SiKned__"'__ 'l7 �'A�t� _-�qpplirant <br />�'-._.'.__ . �_.___. _ ._ <br />:\cceplcd 3 [ �i_"�'�9y/ By_' " �� / <br />, J 'f -- - ---`----�---/ ; <br />/ �.SSerlmmAeni <br />% V <br />