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c,.�d -� vc..:.:.. . � <br />�ca��-� io-�-2f, i?(. . <br />�• <br />� <br />\1'.0. Fbrm d-1Rao-E.P.I'a.-G2G3d • � � <br />City of Everett���Tater Depai�tment <br />1�PPLICATION FOR WATER <br />All blanl:s must Le tiileJ in cr crossed ouL , <br />14�•mett..✓_....J_ �.... . � � �-7�� ............._..192. �O <br />TO THI; SUPP;IIII�TBNDPNT OP THP7 A1'AT R DEPAILT,II�NT: <br />CITY OP I�.��i312TT'P: <br />I l�c:c6Y �PPIy for thc usc oC w:ilcr ir accord:;ncc �rith thc rules nnd rrgu' <br />lations o[ the R'nter Depnrtment, tor pm�pu�es nnd fix'ures slnled Uulow. <br />During the time that :my of the ��'ater mains may Ue ln7:en up 6y rmson <br />nC :viy improcomenLs nuthorizrd Uy the Citp oi i'.c<rett, in or oC nnp +LreeL or <br />r.11e7 in n�hich Ilmg may hm•e been Inid, lhe City �vill nut be reGuired to furnivli <br />waler durir,g the p^ng[ess of such imiirovemmits lu any eonsumer a�hosc cupply - <br />m:iy tLus Uc cut oft, u�jr Ib�e linUlc for nny dum:iges far itv fnilm�c so to do. . <br />Applicntinn ?�o...d..�l._.� . _...: " J's'L .', . I .,. <br />Efl�l�. ._. I " ��/,� <br />�,��k_ � L. __.. _ --C� <br />.. .._.. . .... Lot - , <br />��� /� O-fJ � <br />N�9?.�i.�i�j—. ..../�..,�-�-.� "vb 8tteet� 'L� � <br />v+ t� _,�lLlJIA— ✓;.. L 1' 1�.... ��.. <br />; . .�..�.. <br />9'lie work to Ue cacculed by --..._._ .__ .. ..__. ........Plumbcr <br />Stat% sizc o£ tnp. ;;�' '.:y tidC applirn�ion I <br />.J�,�./._L,._Tnp to be inserted-Yri�h�mnin. ^rnty .,�•pr,B t0 Pny for 'l�„ <br />� - inr.tnllsiio�t of a connoctln.: <br />.._._-..._\�'nter clo;et �� r;ttd ' �n <br />.........:.-:....Bnth . I SUI'1,i:M <br />_-......Urinnt u�;roo to pny a nini�;ur� of �Ynf <br />Z....Plnin inccet �;.,idc y 3.00 per unnth on thir, r:otrv <br />--....S�de tcalk «a=ncr —od connoction r.� ::E;rond upmi <br />1........11o�c Uib out=iac tiy ti�o r.i.t;; Co�atci]. of ;varoti <br />._.... ....Sfose bib for builJi�g pm�poscs 1; . <br />.._..._'.-::...11osc bib it,aidc . <br />.......-_...11ib for stnUle contniniug ..................9lall........._ __.. <br />......... ...Nmnbcr ot Persons in tnmily <br />... 3.....Numbcr oC rooms in Uuilding ,�-� - ^ <br />The P�'emises �rc to be used �s a...._ IJ�LY�'; �( ..:.._. .....__.. <br />Thc own• r of .hc prcr.iises ts.....�%%.- ...(� L.f ex._�. � r i..__....... <br />Then! � . is..._._._ ......................._...............____........_._.._..._.....__._.........._............ <br />;�l:r :i�a, nithuuqh signed, :hall not be binding upon the Citp, until <br />, 1..� '•ic Sup.�rintcndcnt of lhe �Yater Departmenl. /. <br />Signed L ��GF�:Z-Z:Z-(�_... "��.� � z _�Ap licant <br />..�-��._..... 2 . IIy � G � � <br />, . . ..... T .... . . . .... , <br />utendent / <br />� <br />