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� ,�„o.�-- �l�a1 �3\ �'° ^" <br /> �-,.,�� „- �z-a,- �r . - <br /> ' \V.U.Form�—�LUU—}:.P.Co:6-z6�21 <br /> City of Everett--Water Depurtment <br /> ApPLICATION FOR �WATER <br /> p1I Ul�mks musL be t�^°r cro�d out <br /> ..I._�.�.'-'..l........................13�._� <br /> Gvcrett............................ ....... <br /> ^.O THE SUPERINTENllrNCITY OF EYER�TT DEPARTn1ENT� <br /> I hereby npply for the use uf watcr in nccordance with thc rules and mgu- <br /> of the �eater mnins mnY be taken up by rceson <br /> lations of thc V�'uter Depertment, for purposea nnd fixt�u'es stated bc og rect ar <br /> During the time thet uny in or ot anY <br /> the City will not bc required to furnieh <br /> ot nny improvements authorized by the Citp of li�'eret , <br /> nllcy in which theY may have been 1aid� es for its fnilure so to do. <br /> water durmg the progress of euch imProvementn to eny consumer whose suPP Y <br /> may thus be cut aft,ar(��e io lc for n��nY �j°1�g .� <br /> ppplicntion IQo......l� -���.`.........'. �7` • ; <br /> ' ..�I.ot........._..r._�......_........... Add...`�.�..A.t... ...:.....�r.... <br /> Block......................�'..7" .. . � �. <br /> �v�..............Street <br /> No........_,// ./_/._....... .�!-(�-� � <br /> . .................................. <br /> ................................................ <br /> _...... <br /> ....._........._...... ........Plum er <br /> . ... ... ........... <br /> ... <br /> ............... <br /> 7hc work ta be executed bY��,j�� O� , <br /> �9t te/s� e of tsp. � .. � f <br /> f.�TaP to be inserted in the mnin. � � <br /> .....�........Nater closet ... .... . ._.,t , . <br /> i.� � f , <br /> .._�.........Bnth ,_. �,,� , <br /> .......—....Urinal . _. . , <br /> ......2.....Plain inucet inside <br /> ..........�-..Sidc txnik �vnshcr <br /> ,..._.,.(,......Ho=e bib outsidc <br /> ._._.,..--....Hose biU for building Pt�rposes <br /> ..__.,.�7._Fiosc biU inside <br /> ..... - ....Di6 for steLle contnininB....................stall................._. <br /> .� A'um6er of persons in fnniily <br /> J Numbcr of roome in bvilding <br /> ...(p......... _........... <br /> The premises nre to be uved es a......__. � �� � � /����/� <br /> _..... .. <br /> The o�vner of the Premise� ie......._ . .-������"�'" '"/ ............._......... <br /> _.........__..._......._..........._.........._........................ <br /> The ngent is.-..._-............. ......... � on tte City unLil <br /> This ePP��cntion, nithonFh eigned, �fin11 not be binding up <br /> the SuPerinle n he Nnter DePnrtment. <br /> ccePted by ; ppp�� nt <br /> 1/ ..........................._y .. <br /> _ . ..._. l . . <br /> � Signed...,r ... . G <br /> ......... �n <br /> �,,J,,Cf,��_.� ........ <br /> i <br /> ./..192...... IIY-.. .... .. _• ndent � <br /> e .cePted._../:.'�!:l/..:.. . . .� ., .. <br /> % <br />