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9 � <br /> '•.� J�y� ':, _ . . . r'"`�"."� 'r r1�,, <br /> tX�- � <br /> R'.D.f'crm J- ISO�—ti.P.Cu.—�9G.R3 <br /> City of Everett�Water Departinent <br /> APPLICATION FOR WATER <br /> AII blunks must Ue filled in or crussed out <br /> L v c r c t t,........... 9/2....................19^_.`)L. <br /> . <br /> TU 9'lili SUPI:R[NTliI�DliNCiTY OI'�6\1?ILFT�p;nliPAP.TJIti\'1': <br /> 1 hercbe r�.PP:l' far the use nf�caler in accerd:mce o•ith the rnles m:d regu- <br /> lutions oC the 1Cater Dennrtment, for nw'����=�s ������ r������'« �ta;al Lcl�a�. <br /> Dw'in�; U�,c limc thnt :my of thc watcr mnias m.�S in or'�oC i n)'�strcet o,r <br /> of nny in:ProcemonLs :�uthnrized by ihe City of rcerett, <br /> alle�• in whirh ihcy ma}'hnce 6,�er� I:rd, lhe Citp :vill �ml be required to turnish <br /> �v:der durir.F lhr Prugre,a of ruch :mprovements to nny conaumer «�hose supplY <br /> n;.S thus Le cul oi[, or 6e liuide fur :mY <lmm�gcs im• it� taila�e so to do. <br /> Applicnlion Nu.__..:.:�..!:.:...�..__..�..."...._. <br /> IqL...../—" ..1�.-.�. __ Add... . . .. <br /> l�lock......,�-�..Gf. .. ._ . . . ... ._. .. <br /> No. . �•2.0�_....... . .P��—�'61'L.t ....Strect <br /> . .__._........... ._..._.._...._...._ _........_........_......................_......_.............__........_. <br /> .. ..7lic w•orl: to be executed by... ....___ . _ .. _. ..._.__.._._._....._.._...Plumber <br /> State size ot tnp. <br /> //y.....Snp to be insurted in :Ue m�in. r �,: <br /> , � � <br /> ....__�_._\Ynter closet �� "� <br /> ..__�._......BaB� ��' <br /> ..._'.(......_.0 rinal <br /> ....)'..__...Plni:i fnucet �usde <br /> ._�"..__._Side wnik �vusLcr <br /> . �_....._Ho�c biL ool�ide �� j <br /> .....Y._......Hose biU ;or building P�%'Poaes:' � . <br /> .....Y......._}iose biU �nsidc � <br /> ....�.........Bi6 for slnUle canlainin�.._.__..........stnll.............._.... <br /> ....�C.........NnmUcr u[ P�rsons in Am�ily <br /> ._�.....NumUcr o[ ruams in bttilJing . <br /> Thr, p"c,uises nre to be used ^ +���- � • -����� ������ <br /> . . yh <br /> TLe otvnrr o[ the preniises is..///CGI��-. .. ..'f—"' � ....... <br /> ; � ........ ,...._. _... <br /> Thcagent is...._..._........._......._............._.._.....__. . <br /> �pplic:itian, altl.uugh sipncd, sLall ncc be 6inding upon lhc City, until <br /> ar� ' ,�d bc thu Superintendcut oC thc Nalcr Depnrlmenl. <br /> � � I .APplic+mt / <br /> Sicncd.Lll�1•��f. ., ,...,.. .._. ._ _... � <br /> c���j �,,,,,/ uy.f� i.; ' .. / <br /> ., .cd ,. _. -��— � '�'7 .. / � Cup�.rintendent � ' <br /> � �����s� <br />