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` . i �i, - .,i � -�� ��1 <br /> ti;�+'`�4J._ L!}�� ',., , . � <br />� .W.D.For:n 4—I600—E.LCo.—G-:G2d , <br /> City of Everett�—Water Department <br /> APPLICATION FOR WA�'E� <br /> All blanl:s must Ue filled in or crassed out <br /> Everett,........... <br /> ._.............�!'��-/0.............................19`5.'1.. <br />� 10 TF�� SUFERINTLND�NT OI�' THP \t'ATGR DSPAP.T\fENT: <br /> � CITY OF �VI'sR�TT: <br />�' I :iereby appl}• tor the use of w:iter in accerd^:re� witU lhe rules nnd mgu- ' <br /> i latiuns of thc Wntcr DePnrtment, for purl�oses and fis+ures stated below. <br /> Durin� the time thnt any oF thc water mnins mny bc tnken up bY renson <br /> i of any imPro��emer.ts au!horiied by the City of Pverett, in or o_` uny strect or <br /> alley in c:hich they may hn�•e Ueen laid, the City will not be re�uired to furni=li <br /> wnter during the progrc:;s of such improvements to nny cousumer �vliose eup��ly <br /> m:;y thus be cut uff, or Le liable for any damages l'���failure� <br /> Applicntion No..._....��._��-'/�_-......_—�' <br />� . ...... ..... . '. ... <br /> Block........��........................ Lot......._................._..._._.... Add..__..._. . <br />' ,/....�..........................Sfrcet <br /> No......._:�'a�0-.6J. .'-'._.../../.' l� <br /> , -, � q� _. _ __ <br /> __- _ .... <br /> . __... _. ...... <br /> The worl. to bc executed 6y ... . ...����° -� - <br /> �,� _ Plr.mbcr <br /> St tc size of tnp. <br />� �......'fap to be ins�rted in the main. ,� <br /> ,. <br />� .....I.._...�Valer closet r' ___-. <br /> ,, � <br /> .�........ .Pn[h �j� � I <br /> i <br /> ................Urinnl , . <br /> .._4.—.....Plain fimcet inside ,' , - . � <br /> � ... .....Side �valk wasi:er , r. ' � �l`'.��U <br /> ...` .:...........Hose bib outside �'�, �; �'1:'':.;-.;�� \IpifP � . <br /> ................Hosc Lib for Uuilding purPoses '�...'; . ..' .. /,�/ ., . <br /> .... <br /> .....Hase bib incidc . �............. Y�4 <br /> � ....Bib for stnblc containing....................stall.................... <br /> ............ <br /> ......./......_.IQumber of persons in fnmily <br /> ......b......Number of rooms in builuiug�1 ' <br /> The premises nre to be used ns a.._. �..v......... . . .-.- . . .-. .-. ..-.-...-. <br /> 'i'he owner of tlie Pre�nises is.._......_........_................_......_....... ..........__...._......... � <br /> � agent is....._............._..............._................. __._......_..........._......................_......... <br /> . .� npPlication, although signed, ahnll r.ot ne binding upon thc City, until <br /> �-. by the Superin ent o,( the \/Va]ter Tiejnrtment. <br /> • �C�._ Yf—="'�� �cant <br /> � ........... �i . .. �o1 <br /> Sign ..........._ , . •� <br /> ...... ..... <br /> .. <br />� ��—.ld... � , ......... � +�,/(,!� _.. <br /> '� �� � _ - unerintenden�_ <br />