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i <br /> r . <br /> t�...�,�3� Y I�T 1�� '�Ll��-L�P�(� J ' .. 'I' i � � r t <br /> 1 <br /> 1V.I).Porm�1—iGno-.E.r.Co.--G2c..^1 <br /> City of Everett�Water D�partment <br /> APPLICATIQN FOR WATER <br /> NI Llauks must Le fillrd in or crosscd ont <br /> i/ <br />, � <br /> �.-�,�tt.............. ...... ..,...a....y_... ... .. ....�:�::�. , <br /> TO TIIL SUI'ERINTCNPENT OR TISP \C:YPER DI�.PAI:7'SIIs\I': <br />/ CITY OP E\'L•'P.ETT: <br /> I hereby rtpp'y inr lhe U::o nC te:�ter in nrecrdEince tcilh qie ivles and regu. <br /> lalions of the R'nler Depnr[ment, for pm�pn�es :�nd fistures stated bclo�c. <br /> lluring the lime that an�• oC thc tvatcr mnins may Lc laken up Uy renson <br /> oC nnl' improcrmenls nuthorized Uy tBe Cily oC }:cere!t, in or oC nny struet nr <br /> r.11ep in �vhi�•h lher may hnce been lnid, the City �cill not 6e required Lu furnir;L <br /> �v�ter dm�ing lhe prngress uf such intpmcements to nng cmisumer wl�ose su�ipl)' <br /> mny thua Uc cut ofi, ur 6e ]i��Lle ta� :�np d:unnges for its firlure so ta tln. <br /> . ., <br /> � � ( -' �.- — 7//U� <br /> Applicnlion No.......:1�..:..._.::............... .. <br /> 131od_....._—�� '..... . Lot...�� �..�...... ...__... Add. ...._ . ._... .._._ ._ . _.. <br /> v� _��i y _ CU�e�u-�,�.. _ 5tr��� <br /> __ . _ _ . ..._....... ...... _ . . . ._. _ . .�....�.._..y_-.—._ —. . __......._........._ .. <br /> Thc �cm�k to be esecuted l�y.._.__.... ._ v�0�4.�(........................ ......PlumUer . <br />� �S ntc sizc at tnp. �'� <br /> � <br />' �.��......Tap to Lc inserted in thc mnin. ��(Q � �: �. , <br /> ....�.._.......�Pntcr closet �" �\ '; <br /> _1..._....n��n 11/� v , ( . <br />� ._— <br /> ........... ..u�i��� <br /> ` <br /> ._.............Plnin fnucet insidc <br /> ...L._.....Side �vnik tenshcr <br /> ................I�iose 6iU outside J <br /> ...............:21osc bib for Luilding �iur�ioses / Il <br /> ".-..-.:....I;ase biU insidc i <br /> ..�........_Bib for slaLlc contni.�ir.g..._...............stnll.................... <br /> .---.—......rwuber at persons in fnmily <br /> ....... <br /> ....�.......Numbcr of romns in building ' <br /> Thc premiacs are to be used na n . _ .......... . . ....-�'... ..._. <br /> 7'he otcner of the precii�es ie� �_. ��l.C..C. . _.... <br />� Thc agent is.... .. .. ... .. ....... . _.__...__...__.......... .................. <br /> i <br />! Thie npplicntion, alHiough signrd, :hnll not be binding npan lhe City, until <br /> I accepted by t ie Superin�dcn of}lha \1'nter Dep;�rtment. <br /> I <br /> . i6ned..._.....::... .�_.../ .��..........._....... .___/"._. ..... ...App nnt <br /> i <br /> Accepted�....:2�...-.._192� BY......_ . _ ..`;�;a';'�� <br /> ................... ... <br /> / �� Superintendent <br />