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cC..I- ./ <br />� � i � . i_�c.'=r�J� i�l . ... . %I � /� <br />N. D. Porm 1—.IG00—E.P.Co.—L-:6 ".1 <br />City of Everett--�Wnter Department <br />APPLICATION FOR WATER <br />All LI;mL= mu�t '�e filled in or crassed out <br />% - /!' <br />C��erntt ......................:.�%.C(:.. ....l....l-.._..._._....19P,.� �' <br />1'O T1IC SUPEI2INTCNDGNT OR TIIG \YATER/�� PARTt�IG\'P: <br />CITY OF PVEI;ETT: <br />I l:emby :iPply for the use nf e;afer in accordnnce �cith Llie rtiles :md regu- <br />lations of tho R'nler Dep�vtment, for pm�puses :md fi�h�res str.ted bclo�e. <br />lluring the time that nnp ot thc n��ter mnins mny be taken up Up rcason <br />o[ nny impro�-erocnts nn[horized Uy Lhe Citg of Evcrett, in or of mn� streeL or <br />uliey in ���hich thep m:p� hn��e bem laid, thc City will noL bc requircii to furnish <br />water dm�ing the prugress ot sucft imp�rocements to nny consumer �vhuse suPply <br />m:i}- thus be cut uft, or Uc liab,l/e fm� :my damages for i�s fnilure su to do. <br />Applicntiun Nn...._�.Q..7,,.� ..... f� 97 <br />Block..... .....`.1.�.� Lot � / , ....... Add �' � ��%[ .� <br />� �._<..�.. . .. _. ... <br />A'o..,�..�.��._ ...(,t`:.G/ �c_....Street <br />.. _ _. __......__......_..._ ..............._......._ �............ �...... <br />L� / , ...p.._......._ ......................._.... <br />The �vm�k to Ue esecuted bY....../-Y���"-�.....r.s.�o/...� ......................Plmnber <br />F.Cdc aizc of tnp. //y �.S �- <br />.._���....Tnp to Uc inscrM� in tlic mnin. <br />....../........R'ntcr closet �i /. <br />.......C.......Bnth � / <br />........�.....lirinal � � r <br />-.....Z....Plnin faacet inside � <br />.--._-....Sidc }ealk �cnsLcr <br />....... �......Iiosc biL outsidc <br />.......-�.....Iiosc Fib far building imrposes <br />.___`....IIose bib insidc <br />.......-:....Bib for stnLlc containing..........._.......stull ................... <br />�� % .Numbcr uf persans in family <br />..-..4.'......Number ol :ooms in buildiug <br />7'ho premises nr-, to be used ns _.._. .. ,�5/J.,........ <br />.. ..................................... <br />Th� owner of the �remises is._. ..... ' <br />, ; . � 7'� _4,� .................. <br />ri,� ns�„c �s ..................._............._...._..__.. <br />..... ........................................ <br />Tliis application, nithough siFned, ahnll not be binding up,,n lhc City, untif <br />.:epted by the Superintendent of,,thc \}'ntcr Depnrtment. <br />�r,ioa._ �.�./A/.....i�23Y% Bi•_._ �.. <br />C;'...-�e. � ..... . ......... / <br />/ Supc inte� <br />. � <br />