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::um � I500 J-I-17 C. P. <br />CITY OF EVERETT==Water Department <br />Application for Water <br />e\II blanks must bc filled in or crossed nul <br />Everett. _'_'_""'_"""/,[ �� gj2� <br />'__' '__"'_.I __" <br />TO THE SUI'CRINTENDIiN"I' OP'CHfi WATF.R DEPARTMF.�T, <br />CITY OF G9ERETT: <br />1 hcrrby apply fnr the usc o( watcr in :��cordance with the nilcs nnd requla• <br />tium uf 9'h,� Waecr Drpartm �n1, 6rt P��rpmes and fiztures stated 6clmv. <br />DurinK thc tiine that any nf thc wnlrr mains may be Inkcn up by feasnn o( <br />any impruvements authorized bc thr Ciry uf Everett, in or n( any strcet nr allep in <br />which lhey maY hnve 6ren laid, ihr Cil>' will nnt be required �n Inmish watcr durin� <br />�he prapress nf such improvements tu any cansumer whose supply may thus he au <br />nlf. or bc liablc tor any dam,iges fur it� failure so ln do. <br />APVlicnlinnNn.'___'���'�•f " <br />_'. F________ <br />Blnck .._; ��_. . _ _Lat.'3"_ -.Add <br />'I ._ __ -_._.__._._.._. <br />\n.."'.5'T�Q ..� __"'..Strcel <br />'_'" '_'_""'" '�'""' " <br />'_""'__""_""'_ "'_""_'__"_"""""""""'_""""""_"_"' <br />'fhewnrktoberxeculedby.._____"'_" ______._ Plumbcr <br />.____'.____._ <br />St21c size u{ tap. <br />•r <br />--- .-f'--Tap to br inserled in Ihe main. �o � ' <br />_._�_____1Vaterclo�et �� � \ <br />__�_____.Unih <br />-.-- __ _Urinal <br />L� <br />.--_____..Plain fnucctinside <br />.�--_—Sidc x�alk washrr <br />-' �. �Ilose bib nWsidc <br />"—'-'—' usc n � �i�ilrling pwpnscs �� <br />� ----�Nosc6ib-inside <br />—'-".__-Bib aFstablecnntaining..______.. yL•ill___-� <br />--- �, Numbcr nt persans in family. , ��.' <br />_._ �J_.._Numbcr nf ronins in buildinK , <br />7'he premises are tn 6e used ns a.___,.. <br />"' <br />______ __..__ _ <br />" ""' -' <br />The nwner of thc premises is ____... __,_ , <br />ThcaKcnt is .'___'_,_,,.. ___ ..__ ___. ._5/oG_?'___ '_ <br />This applicalion. alUmuRh signed, shall nol be binding upou the CitY� until . c� <br />:epted by The Superintendcnt a( thc \Vntcr Deparnncnl. <br />4/��, /-71 � ,, //%% <br />.. �iiqned._._' 'N'J_o��%?�vJ_l.X-�.. <br />� - --J ; ppJicant <br />Accrpled �/ --��_-.A!�� 7 Ry.. �%��/�7?"_' ` <br />`�, ./�. 4-� . <br />i i :::.mbnr:...� . <br />�' <br />F <br />