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c^ •I.. , . > ii r n . . � � .� ... . � <br /> N', D. Fonn 4 I SOU �-417 C.P. • <br /> C1TY OF EVER.ETT==Water Department <br /> Application for V`'ater <br /> - All blanl � must be filled in or crossed nu[ <br /> Everett�._ _______ `�•3c�__.___._._193�".�___ <br /> '�O 7'HE SUr�.�.:N7'ENDEN'C O�'CHE W/�CER llEFARTMEN'C, <br /> � CITY OF EYEP.ETT: <br /> 1 hurebp apnly (��r tUe use uf wa[er in aceordance with the ru�ee and regula- <br /> ;ions�d'PI:^ Wnter Uzpartm_n[, !or purposes a.id fixWres sta:ed below. - <br /> During the[ime tha[:mp of the water ma'rns may be [aken up b� reason of <br /> any impruvemen[s authorized by the City of Bvere«,i• ��'of any streM or alley in <br /> �vhich Ihey may haae Ueen laid, thc City will not be nq��red to lurnish waler during <br /> the progrc•,s o(such improvements to any rnnsumer whosc supply m:ry thus be cut <br /> , o(L or Ue I�,able far any d•nmages !or its (�ii!ure so tn do. <br /> ' Al:pliCn!ion Nn.""__�.�Z.1�{)__"_' <br /> 13!oc`' )_"'_ '___'_ _�__"Lo[""_ '.'_ ,� Add____'.. "'_-__-'.__ <br /> " Nn.,.G_.3_O_�---�j" .`�__�`-�'-'-..Strret �.: <br /> .___'...__._-___'_"_ . _____..__._____."_______________'______.."'__"_. <br /> 'fheworkto6eexen�ted 'u>'.__________"_.......-_-_'___._____.__' Plumbez <br /> State.^.' e o(IaP. <br /> - .__�__T�p to be inserted in the main. � <br /> � _ Watercloset /� _ �s_ o0 <br /> __"�.__Balh <br /> _______ .Urinal . <br /> ..._._ _Plain fnuce[inside <br /> _ _______Side wnik washer <br /> . -__----l9ca, biboutsidc <br /> _____.___Hose Uib furbuilding purpo�es <br /> _•_'____.Hosc bib+nside "�' <br /> _""__'_Bibtars[ablecantnining..______---stall ______"_ <br /> ____._._'_NumUerof pe:snns in (amily. <br /> .__1�___Number o(rooms in ImildingJ /��� � � <br /> 'Chepremisesamtnbeusedasa_-__�I_ _.�':"_._._"""`�_`��___________ '___'. <br /> "1'he o�vnero(Ihepremisesis ____'.____"___ .-_.___ _ ______________'__._____ <br /> � 7heaKentis _'_'________________________ -____.'__'_"_'. ._____'______ <br /> 'Phis application, although signed, shall not be binding upnn the Cily, until ao / <br /> pted by Thc Superinler.dent o Oic Wnler U p r ment. /) <br /> � � A�i;.. <br /> SiKned__�_ ._"' _ _�!-`�-� -"--.—.--Applican <br /> Aacpted___. _ _._. ___ _1 I3y___ _ -� / <br /> �-3� -�� �__--- �.�,��,�„����-- <br /> I"r.__... .. ....__. _. <br /> .�..._ <br />