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.� '.A ��.ii'}J ' , <br />,. . . _�..-_i»_�l' �-�I_ . <br />N'. D. Parm �..1GOU—flilCo.—G-:G-Y/ <br />City of Everett�Watei• Department <br />APPLICATION FOR WATER <br />All blanlcs must bc filled in cr crossed out <br />F, t�e re t t ................. _........ _........... �/ / ......... _ _ . _....192 f ... <br />TO 17IE SUYERINTl.'JUPNT OF THE R'ATFR DF.PARTn1F.NT: <br />CITI OF L•'1'Eliti1'T: <br />I hrreLy npply tnr the use uf �caler in necordance vilh tite rules nnd regu- <br />InLions of the \qater lle�rarlment, for pwposes nnd fiz'uren stated belou•. <br />Dw�ing thc tim � t,iat nny af the w�ter nmins mny be taken uP Ly rrnsan <br />o[ nn}• imp roemnents autiiorized by the City ot l;��crett, in or of nny strect or <br />❑Ilec in w�hich the�� may hxce been lnid, the Cily will not be mquired lo furni=h <br />water during the pregress af such imprncements to nny rnnsumer �chosr supply <br />mny tUus bc cul ofC, or b�c7 IiapLlc for nny demeges tor ita fnilurc ao lu do. <br />Applicntwn No...... 0 � 1. $ � <br />J` <br />I31oc1:.... . ��...._ Lot......_ � .._..._ _.. Add.. __._ .. _ __.. .. <br />i:o. __ .�1�q� <br />� � � �-�- /� `._..........._Strcet <br />_.. . _ . ........ V ......... . <br />.. ._ ._...._.. .. . . . _ .. ..._.._. <br />The �rork to be ezecuted Uy..._. ._. . . ._. ._. _. . .. .....Plumber <br />Stale Eize of tap. <br />.-_�I� i �_: ` <br />;�. Tap Lo be inmrted in the mnin. ., �� � <br />.._..._�.....R'xtcr dose! ��-� � � � <br />u, <br />� <br />._. ...�......Be[h � ,(� C] 7 <br />......--.--'Jrinnl ��t"I \. <br />V <br />._._ �..Plein fnucr.t in�ide <br />....._--.-':..Side n•alk tvnshcr <br />-....!�......Ilosc bib outside <br />.'....�.-..Hoee bib for Luildin� p¢rpoecs <br />.«....' .—..Ilosc biL ineidc I � <br />.......—.�.DiL for slnble contnining.....____...._stnll_...._..._....... �� I <br />i <br />....._'--..7<umLcr of per�one in family <br />......�._..Numbcr a[ rooms in Uuilding � <br />TLe premise9 arc to be used ns a.._.. .. �....... ... <br />. . . _ ..._.._. <br />The ow�ner of the pretnises is.,_ .._.._ ._._.._._. <br />._.__....__. ......_......__. <br />Thengent is......._..........._ .............___._...............___........_................_.._...__...... <br />npplicntion, allhouqh signed, ahnll not be binding unon lhc City, until <br />'�y lhc Sunprintei�den otth� �Vatcr�Pnrtmrnt. <br />5� �/ � _�:.. � F.��� � . Applicnnt <br />� �. <br />_ <br />. >' ... By .. _ ._ �... <br />_ _. <br />. ........ ................ <br />�`��.+ttperintendent <br />