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��ocZ�o' �7-y--go-/r' r-_� -f r� � �7� __ _ �— <br /> \V.D.1'orm�--IL00-E.P.Co.-R-2L-21 <br /> City of Everettr--�Tater Department � <br /> APPLICATI�N FOR WATER <br /> .4ll binuls must bc fillcd in or crus=ed out <br /> Everett..................� .. .. .....�.�._.........19°30 . <br /> TO TSII's SUI'IRtNT13\DF.NT O� T13E \YAT�I�P.T:1il\T: <br /> CITY OC EVL121iTT: <br /> 1 ��e,�i,y ,���i>. r�� thc u c u[�catcr in arcoraancc ���ilh Lhc rules nnd ragu- <br /> latians nf the 1Vntcr lleparUimnt, fnr pmpuses :md fixtures stnted bcic�v. <br /> Durin� the time thnt nny of lhC trater mains mn1' Le tnken up bp tcason <br /> of nny improecments uuthorixd by ttic City oC IScerMt, in or of nnp strcet or <br /> ull^y in �ehidi ilieg may hnee been lnid, Lhc CiLg �sill not bc rrquired lo furni.�h <br /> �vater durinq lhe progress o[ sucU imprnvrment� lu anp consumer whose supply- <br /> m:.y tl:us be cuL of(, or be IiaLle fm� ::ny clamage� tur ils fnilure so to Jo. <br /> APplicntion No...... '.��....U_?.-� - ���r f .. <br /> Blo�k.....i .... . Lat . . . .... .... Add. . ...._. .. .. <br /> / /J� <br /> Yn� . /.�cf"1l�+z... -�- ' . ...... ./..$tr�ect <br /> �`..�c�..�. l�.,�u�.�y. Gt:z.�cU�.-�.�2�.-x.�'.-Zo---� f <br /> � <br /> The �cork to be execute� �y�... .. . . ... . .. . . . . ...._PluciLer T <br /> f�•y/ �'"'__ <br /> Stnlc size ot tnp. ,� ' <br /> _'3�`f.....Tnp tu Lc inscrted in thc mnir.. <br /> - .__ ._..._..Wntcr closet <br /> ................U n t h <br /> ._......_.....Urinal ,: <br /> . .........._..Plnin faucM 'vside /- . <br /> ._ ...__.....Side n�nik u�nshcr % <br /> .. ...._......Hosc bib outsidc <br /> _.._..__._.Aase bib fnr building purpnsr� <br /> ..__._.......IIose Lib inside <br /> ........._.....IIiU for stnble conlaining..............._...:tnll..__.......... . <br /> ................Nutubcr o[ persons in fnmily . <br /> ................A`umLcr cf rr,oms in building <br /> fhc premisea nre ta be used ns u . � . _� <br /> T!ie o�cner of thc premises i��7�r�.� I �(`.��,� <br /> . ...___ !/ :/ ..._. . <br /> The ngenL is....._.._........................._............... . ..._.........._........._. <br /> ....................._... <br /> This npplicalion, nithough si�ned, ah�ll not be binJqqqinnnng upnn thc City, until <br /> cpted by thc Supc-r�inJtcn/�{�'nL of t6c \V� Dc�� � <br /> Signedl�l/.//.L41'1�-.[^� b'�.._............Applicant <br /> ed ^... <br /> �-_���.:__i�� n .. ...... ... <br /> �'T'e�� ent <br /> i <br /> �-r <br />