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�•.�r� t. ,� a<�_d,' rc�:i S= �s- ��, --ir" <br /> U'.U.Fonu�-1L00—k1P.Co.--L-2GCd <br /> City of Everett-�Water Depnrtmer.t <br /> APPLICATIQN FOR WATER <br /> :lll Llnnks must bc fillcd in or crossed out <br /> I�.ccrelt,.........._......__'��/�..._......_........_ .......1�� <br /> TO 77ll? tiUPIi121N1'INUPNT OF TIIG �YATIiR UI:P.1RT1fIBN'1': <br /> CITl OR �VIItIiTT: <br /> I hcreLy +�Pb�S [or the u,e nt wntcr in a�rordnnrc a�ith thc rules nnd rrgu- <br /> lalians of lhe R'nter Depar[ment, for pnrpo�es nnd Ciz!ures slnlcd bclow. <br /> During lhe limc Lhnt any ot thc watcr mnins mny Uc Nken up by rcason <br /> o[ nny �mProrenunts nutliorized by the City oC licerc[t, in or of nn}' sLreet or <br /> alle)• in �vhich �hcy may hm'c Uren lnid, tlic City tvill not bc required :o furnish <br /> �catcr dw�ing Uic progress ot snch iroprot•emenls lo nn}• consumor :::osc supplp <br /> m::y tlius bc cut/�,nff, or Ucf�IiaLlc for nny damnges :or ils fnilure so /o do. <br /> Application`.ti'�.��_.�..5�..`�.....,_._.- 7 3 �� <br /> �iio�x_....._. �3.0..... ....... Lot._�p ........._.. ........_.. ... .�aa._ _...... ... __... _ _._ _. <br /> i1o..�.�/.7.._.....e`-`-�--'c-TM-��...._.............Strect <br /> . __.._._....._._.__..._...................._...................................................._ ..__._....................._..... <br /> The �cork to be executed bY....-----...��"�'r`�'-..- ........YlumUcr <br /> St tc sizc ot tnp. <br /> „� dV <br /> .�'�..':....TnP to be inscrted in lhc mrin. �/y I S__ <br /> ......�.._....�Cnter closet <br /> __.�.........Dath <br /> .- _...-:....Urinal <br /> ._.`-........Plain fnucet inside � . <br /> r <br /> .....—__..Sidc �cnik tcnshcr ��' <br /> _�.......I�osc Uib oulsidc <br /> ..._.—:...Hosc bib for Luilding Imrposes � <br /> -r�:..Hosc Uih insidc <br /> _ ..-.-.,,....Rib for stablc conlaining....................stall....._....__..... <br /> ...._--:....Nmnbcr at persons in family '. <br /> ......�.�.........NumUer of roou�s in Uuilding � � <br /> Thc promi=es nrc to bc used n/s 7n�. / ... .. . <br /> J< � � . ...._-�_...^ �_..............._.. <br /> 'I'hc owner nf the premises ih,.."../� -'�'I.`��� z.�f--cL..f�i�. <br /> _ ..— U <br /> Thcngent is....._..._.....__._...................�._._��..__...... _.'.. . _.. ....__ ....... <br /> T� �> application, ulthovgli signed, yly++ll not bc �indi �)ion � �ty until <br /> accep 1 by ihe Superintendent of Uro R 'ir De tme . / 1 /A/7� <br /> SiGnrd........................�.�...... . _., I.�l �l .J✓.��/ .��.t?:Rp, j[any <br /> , !�}, - � . .� / � <br /> �ted...�-.��.�.....'.....3'1 .Q By..�J._.... .. . �y,_...:._/'�....... <br /> � <br /> � <br /> L�iLT fi��� , a' ene <br /> _L:- <br />