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�«_�+. � < �- � =r �n-�L.�Lt� � -2 �- � � <br /> `5Y.D.F'arlv�-1$011—E.P.Cu.-6:6.2J � •• . <br /> City of Everett�Water Department <br /> APPLICATION FOR WATER <br /> _lll hlanks must be filled in or crosse�l out <br /> 25 / �4_—> <br /> L'ccrett...................................f...:'Gl.......................15'L.-... <br /> TO 'PHE SUI'ERINTENDENT OF THF. \1'.1TI'sR DEPARTMENT: <br /> CITY OF EVEEETT: <br /> I here6y epply for the use of tenter in :�ccordance with the tvles nnd regu- <br /> letions of the Water UeDarlmcnt, ior purpuses nnd fixtures xtnted 6c1ow. <br /> During the fime thnt any of thc water mnins muy bu tnken u�� Ly teason <br /> of nny improvements nuthorized by lhc City of Ecerclt, in or uf w�iy atrect o,^ <br /> alle,v in which they mny hec+ L�en Inid, the City will not 6e rnquired .o furnish <br /> watcr durin^ the progress of such improvements to pny consumcr whose supply <br /> mny ;Lus b��cut off, ar Le liuble far :my dnnmges for its fuilure sn to do. <br /> ApPlication Nu.._.._� ..� � ' <br /> ......�....._._.... I <br /> Block.....__"..'�.:..�.."............�,ot......._......._.�.1...........3treetd..___...t._..:......:_: <br /> h _.___.. <br /> N�._........r.G .�.�..._.. ./_c-�-,�.�.-(�.eh1 <br /> _..._.........._..................._................_.... ...._......_........._.. _. .........._..................._.... <br /> Thc wmfi to be executed by...._ � . .._._.............Plumbcr <br /> . ..__._.._ .___. ....__..... <br /> S c ?iz; of tnp. � <br /> -�...:...'I'np to be inscrted in the main. V � <br /> ........�..... <br /> .Nater closet �f <br /> .......1...... 6ath �� / �� " � <br /> ._._'—lJrinal �I� J `�� . <br /> .... � <br /> ....._Lc7'Plain fautet ineid� ��. <br /> .......�-..-,Side wnik wnsher <br /> ..._�..H��ac bib oulside <br /> ....��io?c bib fot building purposes � <br /> .�._—.-:Hose bili inside '1 /� <br /> ..._.......,IIib far stuble containing....................stnll.................... <br /> '..—"�umber ot per=ons 'n fnmily <br /> .-....�.....NumUcr of rooms in building . <br /> The ptemisev nte to be used ns a__...._�._ _... <br /> .. a_ .. . . .. ....... ............... <br /> The owner of tliu premises ia..�.tiQ,....C,...._�.��_.�_...__...... <br /> Che ngenE is_.................................. <br /> ........._..........._.............................................._. <br /> � �l�is appticntion, nithough signed, ehall not bc binding upon the City, until <br /> . � �d bp the S�crintm�dent of the Nntr,r DepnrtmenG � <br /> Signed......./��Q....�. ..... . . A licent � <br /> ... <br /> ,..�.-,�...j.� <br /> � �..j. -_..cc,c..........108.� Dy._. -:t�.f�. �..i...'�..;�2............... � <br /> / -5uptzintendent <br /> ` �" — <br />