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�<�� ca/ �r-lz-s�d� . c�.z:�d-. -: �-_ ; .- <br /> W.D.Form�—�LnU--: 'i.Co.-6-P6�R1 <br /> City of Everett�—Water Department <br /> APPLICATION FOR WATER <br /> All blmiks must be fiiled in or crossed out <br /> Everc�c...................._...:..(4,/G 3...........................�93../. <br /> TO TI1E SUPERINTL•'NDF.NCITY OR EVEI2ETT;DF.PARTDtENT: <br /> I hereLy nPpIY for the use ot�cater in necerdance a•ith lhe rules nnd mgu- <br /> latiuns of the R'nter Uepartment, for paipo�es a.id fi<tures staled bcluw. <br /> During the time thnt nny of thc v:atcr mnius mny bc tnken up bY renson <br /> of nny improceroenls avthorized by lhe City a[ F.cerett, in or of anp stceet or <br /> nllcy in w�hich lhcy may hace becn Inid. the City will mt be rnquircd to furni�L <br /> mny lhus�6e cut oft,orebe linbple yfomn�o�dmnages�for�its�ti lure su�togda.����"Iy <br /> Application Ko..../�,O��O����........... <br /> . . Lot............._.............. ...... Add..__....__.. _..__. .___ . .... <br /> Block....._............./........... / .._. <br /> No....�.7....3.1.......��GG�1��.L-..............3treet <br /> .. ........ .... . ...... <br /> ... .. ._. .... <br /> . .... . . ..........__.... <br /> The work lo be ex�ec/u/jed 6y. _��-Gf/� <br /> __ _ ...Plmnber <br /> Slnte size of tnp.Gll��f"'�/i � S/(f % <br /> / i <br /> �fyl._Tep la be inserted m the mmn. �*� <br /> /� <br /> ................Nater doset ,7 � <br /> � i�;-� <br /> .....11nth �' - <br /> ......_... ' �� �-. <br /> .....Urinal ''� ' <br /> ._.............Plain faucet inaide %� ! <br /> � <br /> ._...._........Side �vnik tcashcr .�." <br /> ................Hosc bib outside � � <br /> .__...._..._Hose bib for Luilding purposes <br /> _...._......._Hose bib inside <br /> ................Rib for stuUlc containir.g.........__.._...slnll.._......_._..... <br /> ................Numbcr of Persons in inmily <br /> ...............NumLer ot rooms in bailding <br /> The P�'emises nrc to be used ns n_ __.__ . . _ .__. ___._.__._...__.. <br /> The owner o: lhe pretnises is........._ . . ..-...-.- ..............-............ <br /> .. ...... .___ _.__... <br /> The n6ent is...................... ......_.__..._....._......._......................._._. <br /> . .....__................._... <br /> Tliis aPP��c�tion, although signed, ahnll not be binding upon lhe City, unU� <br /> pted Uy the Supe�rintendcnl oC lhe Nater Dc nrtment� <br /> Signed..L!.[�"°^"'::.!�....lC:..._��?.'.�'..._•. _..........._....................Apr' <br /> � /. <br /> ed_„�/,.L.�......�i1...192._._ BY�......_.. .....�..........�..�.._ % <br /> � - � wrtif�'�' <br />