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i��/jf. -%!� � z 1/ �" � � � t c,�_ �:' l.: r <br />ti ' p <br />R'.U.4brm:—IL00—E.P.Co.-69G�:a � - <br />City of Everett--Water Depai�tment <br />APPLICATION FOR WAT��R <br />All binnks must Uc fillcd in or cro=�ed out <br />Pvcrett� ...................... ���/......3Q.............. _... ..1:12. .... <br />TO TIIli SUl`LRINTEIiDtiN'f OF TI�F. 1\.4'PF.R UtiPAP.TilitiNT: <br />CITI' OF liVliRETT: <br />i hm�eby aPP�S for Lhe use uf n'aler in ac�•ordance �cith lhe rules und re6��- <br />latinns oC lhe R'nter Deparlment, for purposes :md Ci�l�res slnted below. <br />During lhe lime tlmt any o[ t�ie �caler mnins nwy Le Lnken up by nnson <br />of an}• improvemenGs nuq�orir.cd by tUc City n[ F.mrett, in or ot nny stree6 ot <br />nllcy in which ihey may hnen becu lnid, lhc City w:ll not bc requircd to furnieh <br />wnter during the nrogres� uf such improvements to �my consumer �chose supp�y <br />may lhus bc cut oyf, or bc liablc Cor any dmimges fur ile failurc ro to do. <br />Applicution �o.._��.3.Z............ —/ 83 z� <br />Block....._ .............r.................... Lat..............................._._._ Add... _.__ ................__.._... <br />�'o.....'�.31J ��j%..lL.(�,�� �`...Strect <br />�_. <br />�� Y .::.1:. � ' _.... ........_. _ <br />_ _ . ... _ _ _.. ........._.._ <br />The wm�k lo be esecute' -�,p...__.__. _._._. . _ . ._.. ....._._.._.___PI�mUer <br />s � � /�./ a� <br />Sl¢t' /eizc of tnp. �, D <br />..�.�J...T.....Tnp tu bc insertcd in the main. <br />...............�1'alcr doset <br />................Bnth / . <br />. / <br />._.._�.........Urmnl ,' <br />.._::.-,::......Plnin fnucet insidc <br />_.-..:........Side �enik �ensher <br />._�._.......Hose bib oulsidc <br />._. ........_Ilose bib for building Durpuses <br />................(inse biU inside <br />................Dib tor stnUle containing....................stnll............._..... <br />.__....-.......Numbcr of persons in family <br />....�.... ...NumUcr of rooms in 6uilding //q� <br />The premiscs arc to be used ns n .. .. (/ [.� :z.�.... <br />%� ...... _ _.... <br />The a��•ner of the premises i � G��� ��+�"��>-�� UZ<��'._... <br />Theagent is.--...._........._ ................_._..........__.._-__l/_..............................__..... <br />This npplicntion, nithaugh siFued, zhnll not Ue binding upon Lhe City, until <br />�.cepled Uy the Superintendcnt /of th�e \Vnt�r Depnrt_men/t'. <br />Signed.C�..._....�IiLivL1...._�i��..°�'SG��,r!.'.`�.lL......-..�../_.... A Pli nt <br />� �� � �� � <br />Aacpted....%�=J�'�P..192.._.. �Y-. � � .... ...�: :/!!.i� ........... <br />�.Il.,'../.� <br />_Syp n�ndent <br />