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� c. ,�.�..�.,- �� ,. <br />�._„J..�.�..�,x � — q _ y� %i�v� <br />1�. n. Fo:m �—�cno—E P.Co.—L-=G2� � <br />City of Everett'—Watar Department <br />APPLICATION FOR WATER <br />:\11 filnnks must 6e fillcd in or crossed aut <br />I:ccrett........._ �/..}'./........._.........._.........._1T�...... <br />i'O Tflti SUPI:RINTGRDE\9' OF Tlll: \PATI'sR DI4PAR^1J1tiNT: <br />C1TY OP EVPI2GTT: <br />I licreLy npply for the u;c oC «'atcr in a^cord:mce w•ith thc rules and regu- <br />lalians of thc «'nter DepnrtmenL, tar purpnsrs nnd fistures sLdrd bclo��'. <br />Durinq Lhe :ime thnt nng oC thc �v:iter mnms mny ��e lni:en uD �S r�"" <br />uI1rY in��vl�u•l�ehe9tma} hnvezbeen}Inid, {ie�C Y'��ill nut1im�rcquired�totfurni=U <br />o�nter dm•iug U�c progress ot sarh improcements to nny cunsumer �vLose supPl;. <br />may lhus Uc cut off, �/ � ab for mS dmm�Res Lor its Lnilure so to do. <br />/. �plicntion No. . .. . ... .. <br />.__.._... Add.J`.� . o1L�' �i(...._... <br />ac.�. 4> _. <br />ui��k..ifLl ..............._.__... _ <br />xo.....o`�.C1..ot..�f.c� r4��-.........._.._.........._. .scT��o <br />__.._._ ..................._...._......_____.._..._............__........_..__ __... <br />.. . .._.rlumbcr <br />The �vork to Uc exccuted bY....._ _...._ ._. ..,._ .._.. __...... _.. . <br />Stnle size ot tnp. -----� � <br />..�<.Y....._Tnp to be in�c�;e;l in thc riain, � <br />.. �........_.R'ntcr clos'et <br />..�......_...IIath <br />. L�......._Urinnl <br />.�......_..Plnin fnucet in.idc <br />_...`...... Sidc wnik �cnshcr <br />..�............Iloee Lib outside <br />._�-.......Hose Lib tor Uuilding purposev <br />...`-.�......]Iose Uib inside �., <br />...�.-.;�.......IIib for staLlc contninin�........._.........stnll.�..........___. <br />c— <br />................Numbcr ot persons in fnmily <br />^,,,�5,,,,.....Numbcr of mmns in building <br />Tl�c premises nrc to Ue used as n .._ .-. . .... . ...... <br />. . ��.� �GCv7�L...a-c;� ....... <br />The o���ner oI lhe Prcr.uses is.. /•' 1� <br />. ............................. <br />.. ._/l............_...._.. . <br />"he agent is....._ .............._.....__.._._......_.._... . (/ <br />Signe< '.. :.. . P ding upon tUc City, until <br />� ent. <br />h;a n l�Fe SuP�nntenl ntsof��lh� ����nricr���e�� J.._..._APPlicnnt <br />, . r <br />y� ., 4 `_`�. <br />a ..Cla ....1 � / <br />S-- �.5. _iaz...... B}.,��Q� <br />������ SuPerinlendent <br />