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'�..�—�rr ).-74,- i1,. �. . .. . .. -�� � ' , ,�. <br /> \V.2 Form/--I[np—F..P.Cn.—b-TG.! • <br /> City of Everett�Water Department <br /> APPLICATION FOR WATER <br /> All blanl:s must bc filled in or cra�sed out <br /> Everett........................._...�.'./�/.�._........._.._......1:)2�. <br /> 1'O TIIE SUPliRINTENDENT Ob` TIIF. R'A99:R DGPAI2TDItiA'T: <br /> CIT] OR liVERliTT: <br /> I he!�eLy npply Cor the nse ot water in :iccordance �cith t?�c rules and regu' <br /> Intions aC the �Vuicr Peparlment, for Pm�po�es nnd fis:u:es s:lled bal,�c. <br /> Durinq the time that miy of the �vater m:�ins mny be talcen uP bS renemi <br /> o( nny in:Proc.anents auU�m•ized Uy the Citg of I:rerett, in or ot nny sLrceL nr <br /> alle}' in n�hich ihe}� map hace been laid, lhe City a'ill nut bc rcquired tn furnish <br /> wntor during lhe proF"esu ut such improcements to nny consumer �vhose supply <br /> may thus Uc cuL ufL, or bc liuble Cor any damngcs for its fnilure so lo do. <br /> S'�f: ° �^ <br /> Appliculimi No.................... ......_...._... <br /> , r � <br /> 131ock....../�� �� .'...... . I.at_ _. ........... Add..__..... . ..._ . _ .__ .... <br /> No......../.aC.d..� .... .. .�....Street <br /> .. . _._.._.. . _.. ..._...... . . ......_. ._._ . .. <br /> The �cmk to Le esecute<I bp.._. . ._. ..... . ._.._.._ _.....Plumber <br /> S�tn�te sizc of lnp. <br /> ./l.�j......_T��p to Uc inserted in ihe mnin p0 <br /> / �-' <br /> _._...�...._l�'n.cr closet �� <br /> .......L.......Ba�U i .. . <br /> - <br /> f— . <br /> _ ................Urmnl . . ,,�, <br /> _�--.......Plain faucet insidc �" .�� ��.. .... . . <br /> _...`..........Side �calk �vnshcr �-� . ' .....�� ;.�r..� �; .� . <br /> ........_:...liose Uib oulsidc � � ; ..; �� . .. ..� �•:. . <br /> -_--r..—._Hosc Lib for Luilding pm•Pose9 \� gYn I\_,`.:.�.\.�.`r <br /> ,�„_._..IIusc bib insiJe ���I \ <br /> -...._�-.BiL for stnLle contninin�..............._���. <br /> ........y...Number ot persons in tnmily ;-. '"�� <br /> ...._",2.......NumUcr af ronms in building � <br /> Thc �)1'CI1115C9 nre ta bc csed as a..,.n � � � �1 -�. . -....................... <br /> -` � o�vner a[ the Premises is___N:�. .>. _.i""___.:-.._..'�r.�7...._.........___.. <br /> l ' <br /> }{ � agent is....._ . .... . ......__ ........... . . . _.... .... .... <br /> ��`���` �pplicdian, nllhougL signec h�,ll �ot be UmJing uPon the Cily, until <br /> n y the Su��crm dcnt o e ct Dc lment. <br /> . j�(� P <br /> Signed. d�-C..... . �� _... . �...P.pplicnnt � <br /> / � � i <br /> ` -=7.C/��...._102� IIy_ ... . _. ... ._ .iY��,�,........._.......�. <br /> . .. .. _--�'L���ntendent � <br />