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�nTp /�I,i�%5 -�[I. -C�J�LI_� � � _ , _ .' j ';. „ . <br />\1'. U. Farm 4-IR00-E.CCo.-6-R6-2! <br />City of Everett�Water Department <br />APPLICATION FOR WATER <br />A11 blanAs must be filled in or croased out <br />F.vcrett,....._/..,1..,..../.7:...5. _.. ....._ ..................... ...192...... <br />TO TIiE SUI'ERINTENDENT OP TI�F R'ATER DEP.�\IiTDiE:iT: <br />CITY OF EVEI:ETT: <br />I hereUy npply for lhe use o[ �vnter in accordance with L':e -ules nnd regu- <br />Intions of the Weter Depnrtment, for purposes nnd fixtures et:rted bclow. <br />During the time thnt any of thc wnlcr mxins may be tnken up by rcason <br />of nny improvements nuthorixed by lhe City of Ecerett, in or of any alrcet or <br />nlley in which theS mny hnve been lnid, the City will not be required to furninh <br />wxter during Uie Progress ot auch impro�•ements to any cnnsumer whose supply <br />may tlms Le cut off, or br. linble foc nny dmm�ges for its fnilure so to do. <br />Applicntion No....��..��....._......._.... _�. <br />Block .........................._ Lot............. . Add...'�...._ :.. __._..____.,.... <br />............ ...... . . <br />.. ........... <br />A'o.....�..3..�_.��....,-2�'(r'� - �:StreeG <br />. . . ....... . . .._....._.._.._. .. _. <br />.. ._..... .____.......... <br />......._ __....._._ ................................ .. ......... :.^.. ... <br />The ��•ork to be executed by._._-.G.:�l .�-�__ _ ...............___.Plumber <br />Stnte eize of tnp. � <br />..�a.....Tnp to Ue inscrted in the mnin. <br />.._1......_.Naler closet <br />.....�.........IIath <br />..... �:.....Urinal <br />..._$_-.....Plxin fnucet inside <br />..._�......Sidc �vnik �enshcr �/' c,i <br />....�..........Ilose bib oulside `�' _ = � <br />.._�.::...._Aase biL for building Purposes �..1. , . <br />_�:.:....._7iose bib inside ��: • <br />/i,il, �7 ;. <br />...C.::..'.....IIib for atnble containing ....................stall........r.�. � � / i <br />.._L-.......A'umber of peraons in family <br />�.......NumLer of rooms in building , <br />The Premisea nrc to bc used as n........��C.������----�-� <br />The owner of the Premises is.�.._..�_.L[.��C�..(.-4�v+-.�-��--� <br />Thcagen6 is ................................._................._._......._...._........_................................_.. <br />Tti:� epplicntion, nithovqh signed, shall not Ue binding upon the City, until <br />sccep�eu by the Sv�ntendcnt o the Nnter De���v�.y p <br />4r p� � <br />Signed.. � � plicnn� <br />........................................._. _.. _ ........._/-;#�/ <br />i— ' .rda " V - <br />�.....�..�...�._;..-7^..�_—...192...... BY.� .r. . ....._........ <br />' Zendent <br />0 <br />