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vct��' S-�f^2T-ff E-,--�,u"=._.v.'-+—i-�a�t :: �:,,� , <br /> W.ll.Form�-�1GU0—E.P.Co.-6�Ru-21 <br /> City of Everett--Wa�tei� Depai�tment <br /> APPLICATION FUR WATER <br /> All Ulnnk3 must bc filled in or crossed out <br /> Eve rett..........................Y....�Ni._.........................132..A.. <br /> TO TIIE SUPfiRIN'CCNDF.N1` OR THF \VATBF, DGPAI2T1fENT: <br /> CITY OF EV1'sZ�:.: <br /> I hereby nppty tor the u:+c uf«�nter in nccordnncc w•ith the ruirs nnd regu- <br /> lations of the Weter Depnrtment, for pmpo�es nnd [ix'�.ures stated bclow. <br /> During Uic time thnt any ot thc tentcr mnins mny be lnken up by rcnson <br /> of nny improvenents euthorized Uy thc Cit}• of F,cernit, i, nr of nny atm�t or <br /> ullcy in a•hich they mny hn�•e becn Inid, the City will nat bc rn�,�ired to furnish <br /> w�atcr during thc proqress ut xuch improrementv ta nny cnnsumcr vhose eupplY <br /> �»'�Y thus L•e cut otf, opr bcf�lia l7o tor :mS dmm�ges for its tnilure so !o do. <br /> APPiicntion A*a.....Q...G...�./.........._._� �) 3 G'� <br /> aia�x.........�..7_�.. ....... oc./.._...... ..... aaa._ ..... ...... J , <br /> /� l l _ .._... .. <br /> _.... . <br /> No....._.,l 7...��......... . !.�..1�'� . SLeet <br /> .. _............ .. ............_. <br /> ......__....... ._ ........._..__..........................._......_.... .._..........._.........._...................................... <br /> Tlm a•ork to be executed by�._. .__....Plumber <br /> 5-�,.G:._ ..__. ..._ _......... <br /> Stnte aize of tap. % <br /> ...�?.-...Tap to be inscrted in the mnin. <br /> --..L........Nater closet <br /> ....�.........Bnth �. <br /> ._..:.-......Urinal <br /> .._f.�.,.......Plnin fuucct inside � <br /> ..._.: ..._Side wnik tcushrr <br /> ......r......14o�e bib oul=idc <br /> .._._-.....Hocc hib for bui!ding pm�pa;cs <br /> ....... .....17nsc bib inside <br /> ......... ...BiU for slnble coninining............._.....slnll............. <br /> -...../...'.......Numbu• of persons in farr�ily <br /> .....Y.......NumLcr of rooms m UuJding <br /> The Premises nre tn bc used ns n . .. (���.� � <br /> . . ...... .. <br /> "'�^ owner of the premises ie � ,.�� � ._� .� - <br /> � � <br /> 'nnt is.......... . <br /> . ... _._. . _......_.__........_...._✓..._...................... <br /> �.;dication, nllhouqh signed, ;hall not be himiing on lhe City, until <br /> Lhe Superinten / [ tUe �V tcr Deparimen/. <br /> acd../�_.. .� .. _ _...__.._.....�.Applicant <br /> � �.. <br /> . ....... .... ._ . <br /> .. ._ _........_._. <br /> � ....._..................... <br /> _ ��`,,,2!_% Superintendent <br /> J <br />