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�.,.,, ... �' y-� i7 �•_�S, z.. �'/ <br />W. D. Fbrm �-:500-F P.Ca-g.R6-21 , <br />City of Everett�--Water Department <br />APPLICATION FOR �WATER <br />All blanks must be fitled in or croseed out <br />Everett ................._ �..L�..-.�--......./_�...........f ....192..5... <br />TO TfiE SUPERINTGNDENT OF TIi • 'ATER DEPARTnfENT: <br />CI'�.�3F VEP.ATT: <br />I hereby npply for the use of u�nter in accurdance wilh lhe rules nnd regu- <br />lations of the Water Department, for purPoses nnd [ixtures slnled below. <br />During the time that any o[ thc water mnins mny Le taken up Ly rcason <br />ot eny improvements suthorized by the City o[ F..�erett, m or o[ any sLrcet or <br />alley in which they mny heve been laid, thc City will not be required to furnish <br />wntcr durin� the progresa of such improvements lo any consumer whose supply <br />mny thus bc cut off, o(r /be lieble for an,y damnges for ita failure so to do. <br />Applicetion No.....L..�l:...��.. �............ � L�'� � Q �� � � <br />Block.....�.oS..!:i..........._........ t.... ....... .... Add..... L`..'_. _'....._`"'.`="...�._"'� <br />xo...../ _�3.1.y%��-, .:..........._..... sc,�c <br />__ .......... . ... �.!_.J,y................_...................._..._......._...._..._.._..................... <br />t..C�.'.. <br />The wark to be executed by... ..... .. _.......__._..........Plumber <br />Ij . /.... ._.....�.� <br />Slat eize of tnp. �� l�� <br />..�L......Tnp to bc inncrtcd in the main. <br />.._F..........Neter eloset <br />.......'...Bath <br />..._.�.-....Urinal <br />.�....Plein fnucet irside <br />. — .:.Side walk wesher � <br />.:1..._.......Hase bib outeide <br />......�--.—....Hase bib tor building purpose � <br />......—....Hase bib inside <br />.......—.-...Bib for atable containing ....................ata0.................... <br />.._....—..Numbcr of persona in fnmily <br />.. �....Number of rooms in building <br />The premisea arc to be ueed as e,� .__...� ... - _,_.__ ............. <br />� ` <br />_... <br />� <br />'['he owner of the prer.»ees ye ._.��./��- �.�... . q �f <br />� .. /� ..... . <br />1'he ngenL is ..... ......... . . _...... ._... <br />.._F� ..._.. <br />/ : <br />Thia applicatian, elthougK x�ncd, ehall not be binding upon the Ciry, until <br />^�eptxd by the Superintendeny of ihe�N r Dep/nrtm�ent, <br />✓ � il�Z�G �i <br />� gned .. ......... .... . .... .... .... r.,... ...dJ �..�- p cant <br />_......... :' . <br />r. � li <br />_ � <br />� d.....i�....-.� ..............1 .. BY....: ....... L�/ <br />. .. .................... <br />erl endent <br />