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P �= � n �_ � •: - , < � l+f . , - . . �..,.,��-�—�( <br />� r �f — ?�- l:•��� <br />W. O. I'orm J -1l00—E.P.Ca.—f-^.G.21 <br />City of Everett��—Water Department <br />APPLICATIC�N FOR WATEF, <br />All Llanks must be filled in or crossed out <br />Lccrotc ............................_......_'�L..Lf.....................lsz..�%. � <br />TO T(iE SUPERINTE:IDEr'f UI' TllF: R'ATIiR llGPART�fENT: <br />CITY OI' EVliItL•'TT: <br />I hcreby npp!}• for thc uve nt n�utcr in accordnncc �eilh thc rvles nnd regw <br />Intions ot Uie \5'ntrr Depnrlment, far purposes nnd fi�tm�cs statecl beluw. <br />During tlie lime thnt miy of thc �vater m:�ins mny Ue lnken uP �Y rcason <br />oC nnS improecuwnta nulhorized by Lhc City o[ Ecrrett, in or of nny sLreet m• <br />nlley in which �hey may hn�•c bcen lnid, tUe City �vill not be requirod lo furnish <br />«'alcr during lhc progress o[ such improacmrnts lo �my consmncr �chosc suPD�Y <br />may Llms be cut off, or be ]inble for :�n}� dmm�ges [or its failure so to do. <br />Applicntion No......._.!�_�._I`:�.� ............. <br />Block... .... I .:.i/_� I�oL� ...[.� � �. ....__. Add.. ..._..__.. _....._... <br />Ko. .%�oo �_.._4.`--`—`,'�C-'—R�-�..._.. ...Street <br />The �vork lo be execuled by___......__....... __.... ___._._...._._..__._ _....Plumber <br />S��tnte size of lap. <br />�...�.....Tnp to be inserted in lhe mnin. J • <br />u <br />.._.�.........R'atcr closct � p � <br />... .. . I3nth �/n� <br />�. . ... ... � ( <br />............. ..Urin nl <br />................Plsin faucet inside <br />...............Side �enik �easlwr <br />_._........_.Iio=c biU oulside <br />...............Ilosc Uib for UuilJing purposes //i <br />_............_iiosc biU insidc � . <br />................IIiU for stnLle coutaining....................stnll..........�..._.... <br />................Numbcr uf r.rsons in tnmily <br />....7......NumLcr of roams in building , <br />The premises nre to Ue vscd ns n..-,%LP/1cr��,:Q-E,�.. __ ...__ . <br />The o�encr ot thc premises is ................._�.....�/7_Q„Q_i�,-a,�r�c ._. ... <br />Thcngent is ...................._........................__....................................................._.........�... <br />This npplicntion, nithough �igned, ,hall not bc binding upon thc City, until <br />nccepted by the Sunerintendqnt of the Nater Depnrlment. <br />/� �. �/' <br />Signed...11l<_�._:.t,i.(....' �Lk.�:f..,..._.._...... _.../_ .. . / Applicnnt / <br />Acto rtcd � / ....... � <br />.I ....�...��..........192..��.. By.. �. ,. ..c� � ....................... .. <br />�uflerintendent . <br />