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Y� <br />.: l4 CI.�J-i�).DJ ` � .A�l-� i1 J . I �' . _ . . . . <br />lV. U. Ibrm {—I600—E.P.Cn.—b-2G8� <br />City of Everett-�Wnter Depai�tment <br />.APPLICATI.OI� FOR WATER <br />All �bl:mks mu=L Le filled in or crossed out <br />icmrolC ................._.. ��f �_� �_. <br />................... . . .......................192..... <br />PO TIiE SUI'lRINTENUENT OF TIIP•, \PATBR llEPARTB113NT: <br />CITY OR 73VEI:ETT: <br />I hereby npply fnr the u:�e nC u•ater in :reeord:mce �eilh the rulcs nnd regu- <br />lations of thc R'ater llepnrtment, for pm�poses mid fi�'m-es statnd belo�v, <br />lluring tLc lime that nny of lhe �vnter mnins mnp l; taken uP Ly renson <br />of anp iiuprocements nuq�orized Ly the f,ity of Fn•ivett, ir or nf nny strceL or <br />nlley in t��hich +hc�� may hace Ueen lnid, tlic City will noL 6c required to tm�nich <br />tcater during ihe progress ut such iutprncemrnts to nny cnnsumer whosc supply <br />may thus be cuL off, or( �bc linhl�tm• miy d:unagcs for its tnilure so to dc. <br />APPlicnlion Na......Q.,�...J <br />n...................... <br />Ulock ..............�...i..-- _..._....... Lot._G_.-...%........... � <br />....y] _ ......... Add........_ .. _...._.._ _..... .. <br />Na......�.i9 �.�...._...Lf{r.(.1..�7iJ�r.�` ........................Street <br />. _ __...._ . ..... .. .. ._.... ........ . ....... <br />, .. ....._ . ........ <br />'PLc ��ork to be esecu�ed ty ......... . . . ._._. ..Plumbcr <br />_. .._.. . ._ _. <br />Stnte sizc of tnp. <br />._��...Tnp to be inscrted in tlie main. <br />....�..........\4nter closet <br />....�..........Bath <br />.....`......Urinnl <br />......2,......Plain fnutel insidc <br />_....._�:....Side teall; �cnshcr � <br />...._�_...ftase bib oulside s' <br />.....`.....Hose Uib fer Uuilding purposes � 9� <br />...... '�7� L <br />..._L-..._Huse hiU inside �� /�' U � -� <br />.....C.r....DiL fnr stnblc cnntnining......_...........slnil..........._.. � . <br />..... � ��. 0 <br />_....C,-....Nuntbex o[ persons in fam,.y <br />.--�o..._...NumLcr o[ rooma in Uuildi:ig �1 fi3 � <br />The premises arc to Le used ns n..._ __....._..__ ........................._ <br />_. .. _......... _ _...... <br />The o�ancr of lhe premises is....�.._.....7�.p--�..�`._............ <br />Theaqent is ............................................... . <br />. .. _ ................................................................ <br />This npplication, plthouqh signed, ,hnll not be binding upon the City, unlil <br />necepted Uy lhe Superintcndent ef the \Va�cr IJ nrlment. <br />yv�� — s��.._ <br />Si ned.,�{ �—FiJL}/ � � <br />B '..,- ..................l�.�iG'.%.'!.:-./-.7.Lx�; �C�..........A�licnnt <br />/ / <br />Accepled+�....-.L�-.Z.� i. ...lpE...... By......... � , 7 / <br />......�_�?�./�"�r. � ....... <br />/ ✓/�� � �eci7tfhLdent <br />