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j5.](1�. �t- �' -i�1' ' .I <br />,�� � ' . a-.-��- `Y-YO � �l�! /�l7', � <br />W. p. Form �-1f00-E �.Cv.-4-26.2/ <br />City of Everett�Water Department <br />APPLICATION FOR WATER <br />All Llanks must be fillcd in or crossed out <br />F.vc^r tt .............�,.U... ._........__............................19�.5.. <br />TO TIII's SUPERINTE2Fll1•;\T OF THR R'e1TF.R llF.PARTilIF.I�T: <br />CITt OF 7's1'I'sRETT: <br />I hereUy apply tor the use oC �cater in :,ccord�nce �cith llie rulrs and regu- <br />Intions o[ thc R'��ter UcpnrLment, Snr purpoecs ��nd fix:ures sl:dal belo�c. <br />During lhe time thnt :my nt the n�ater maina mny Le taken up Uy renson <br />uf �ny impruvemer.ts uuthorized by the Citp o[ Rvcrctt, in or ot nny slreM ar <br />allcy in a�hich Ihcy mny hnee Leen In�d, lhe City �cill noL Lc required to furnish <br />��'.�ter Jurin� ihe pro�ress uf �urh imprnvements to nny cmvumer �vhnse supplp <br />mny Lhua bc cut off, o�r ibc �l7iablc for ::nS dmm�6es for its failure so tu do. <br />Applicntian No..._6..�._/...�"� .................. � . <br />i , <br />Block. ....... �t� ... ot... � ' _ .__.. Add.__._ :' - . . <br />. _...... .. __....._. _.. <br />No .�_Q...3.� . ....Ls�i!��..Strcet <br />.... ..__.._..._.........._... ..._._.. . ....._._. . _.. . ........_ _.._.. <br />The work to Le execuled by..... .�,Lr-1if/�-.��„ .....Plumber <br />Statc .:ze of tnp. <br />....��¢_...T: p lo bc inecr:eJ in thc m�in. <br />..._J........1Pntcr closet <br />_...i.. ......Dn; h <br />._..<.-.....lirinal <br />_...7.......Pln±n fnucet iuside /� � <br />....L.....Sidc «�nik wnshcr (y/ <br />]io=e bib outside l <br />_ __�._.._ � � <br />......�...I1ose Uib for LuildinFt purp�:eea <br />._._`_Aose Uib inside �-�-�� . ;^ �,-�— <br />.__1..:....Bib for stnLlc emdaining............~....slall...../...��........ <br />...__�-..-...NumUcr of persons in family <br />...,� ....Numbcr oC tooins in building � <br />The prrmises nre. to be u.sed as .. ��...�. . ..__....... <br />- ^ .�,.vn��r o[ tiie premises is__�...,.�.'. �„�. . <br />_ . . .. ... _..... <br />�t is . ........... ._.__._.. ___.._ _...__...____..._....__.............. <br />.plication, nithough signed, alml] not Le binding upon p�e Cily, until <br />.' e Superinteudcnt ot t e\5'ntcr Depnrtment. <br />Q�_ � ��� - <br />?igneJ . . . .....Applicant / <br />_.... . <br />_.. .__. .. .._.._ _..__102.__. By . � <br />s� A.,/'�� � � Superintendcrt <br />2 b -2_5- �-r--- i � <br />