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;'��-� �I � z 9 r r <br />N'. U. Perm �—IL00—F P.Co.-6-46�1/ <br />.. • lL��!' 3�C�-i9 -r <br />City of Everett�VJater Dep�rtment <br />APPLICATIOhT FOR WATER <br />All blanlcs must be filled in -or crossed ut <br />L�•���ic ............................�` .G._..... ............isz�' <br />TO Tlil; SU3'lRINTENllIiNT f;r TIIIo \VATEit llEPARTJIF.KT: <br />CI'iY OI' EVLI;ETT: <br />I hereLy nnply for the u�z af w•nter in accerdnnce a•iih tLe rules nnd regu- <br />lations nf Lne R'ater Urparimaut, for purpuses :ind tixim�es sL•LLed bclo�v. <br />Duri»g the Limc lhat nn} of thc «�nlcr mnins mny be luken uP �S :enson <br />oC anp improvcnunts authorizc�l by thc Cit}� of Iiccrclt, in or of imy sLrect or <br />alley in whicli they may hn��� Srcn �i.ld, the City will not be mquired to furnish <br />water dm�ing the progress of sucl� ironrovcmrnls to nny consmuer a�liose xupply <br />may thus Uc cut nfC, or vUc lGiable fur :my damngeq for it�s fnnilw-�c so to do. <br />APplicalion No.._....0..../..��.......� �2e�1+- <br />Dluek........1���.r'. � 7 <br />.. .. ... . Lut........_ ......................_..... Add.. _. ..... __. <br />�Jy�{., . _.....__....._. <br />No.. �.�..'f _� (/ .i-'..+� /c''ec_.''—.... ....._Street <br />�',f/a , .��c<�,c� <br />� .... __._ . <br />_ ._........_ ....................................._.. <br />Thc �eork to be execuled by...._....._.. .. ..... ...__.. .Plumber <br />. .... . . . .. <br />State size of Lnp. � O �G � :-� '�"' '.� -�,` ���. `� . <br />� � �� ����<yy <br />....j�'l.=:.-_Tap to be inaerted in the main.` " �' � .-��. �;, ( 1 , ' ; � <br />....__.._.._R'atcr doset I.,.�•.,. , -. .. .�i,. �' <br />i . �.. . �i. .. <br />.._............liath ,� ..... .. <br />� <br />. .� _ ...,.:�,r f. �, <br />..... ... ..._Urinal -��. <br />........_......Pluin fnuceL inside <br />...............$i�C WU�� {CRS}ICt <br />...............��OEC Vlll OO�tiI(�C <br />.... ........_fiose hib for Luilding purpoacs <br />......_...._..Ho�t biL inside <br />................IIib for slnLle conlnining....................stnll................._. <br />................Number of persons in family <br />.............._Number of rooms in buildirg <br />1'hc premises are to Le used as a o <br />._. _ ..............`�..:... <br />� __...�........._... <br />The owner o1 thc Prmnises is..;��,lL(��__. Q_��f�� � <br />Theagent is ................_..........................._.... <br />. ..............._........................_....................... <br />applicalion, nithouqh si�ned, shnll not be Uindin� upon klie City, until <br />.: by the Snp/c/rin�tendcnt of lhe R'ater Depnrtment. <br />',me�'(/1..�..t.¢te.....QL��...�......� ..!A.L.... plicnnt <br />, / � � <br />-�tp-..c„�.�%192...... I3y_ � <br />., ..--'-..._...,........... <br />� ,�,�,,; S�perintendent <br />