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. . .y � . <br />� <br />` <br /> '�-,%:i.�.�.�f;. ��� , ;.. f . . <br /> �-.,,1���-c}' ��-2 '_; 1? `',n <br /> N'.D.Form a—ISUD—E.I'.Cc.—G-2G.24 • • <br /> City of E-verett�—Water Deparhnent <br /> APPLIGl'�TION FOR W.ATER <br /> All b�-nks nmst bc fillcu in or crossed out � <br /> ' — ...1'J2. ... <br /> .._�..................... <br /> �verntt,.........._..........c......_...... _ . <br /> 1'U THE SiiPLRIiQTCivDF.NC[TY OFI�VG�TZ;DEPARTDIliNC: <br /> I hereby aPP�Y for the use of a�:dm• in accordnnce with the �vles and regu- , <br /> lations of thc Watcr Depm•tment, fnr purPoses nnd fixtures stuted Uclow. <br /> During the time thut nny of the «'ater m;iins nu�y Ue tzken uP ��Y rcason <br /> of nny imPro�ements uu:hm'i::ed by thc City oi T:�'ccett, in or nf any slrceC or <br /> ulley in wliict 'hcy m:�y have Ueen l:�id, thc City wi11 not be required to furnish <br /> �e::ter during the pragress of such improcements to �my cunsumer whose supP�l' <br /> m:,y thus be cut off, or�/L/e IiaUle or ;�ny d:images for its f:iilure so to do. <br /> Ap{�licntion Nq.._..�i...V.�.�....,.-�.. 7 /52 <br /> � ,•���'� / . ... Add..'.._.., , . . ;_._. � - <br /> Ulock........._..._.................. Lot--............._... ...._....... <br /> _..............._. <br /> q ���)J___ — ` <br /> No._....0�7__.1'.!.. ..�K-.._..._.._..........Street <br /> . ..... .� . .. <br /> _ 1 � <br /> . c� � t . . ...... .. . _.............. <br /> � \..( . G`c�L�� <br /> 1hc work to be eae�uted Ly. . � ..._ _ Plumber <br /> ! Go <br /> Slate sizc of tap. � 2 �� — �J� <br /> .�2c...'fap to Uc insertie:i in ffie mnm. <br /> _.__�..,....R'ater closet <br /> ......�........Bach ., .;�. . <br /> .........-...Urir.r.l .�' . <br /> ...._:Z....Plni:� faucet insidc � ,�� <br /> .......... ..Side �cnll: �eashcr . <br /> .__..�.......Huse Uib oulsidc <br /> .........-._Iiose biU i�r Uuilding purposes <br /> ........'.-....Hosc biU inside • <br /> .........�..13ib ior stuUlc containing...................stail................... <br /> ...._...-...A'umUcr of persons in family <br /> .......~✓.f�umUer of roonis in bui'.ding �, n <br /> The PL•enises nre to be used ns a..._�/...-_y.� L'��w�" �0 . ........... <br /> _ ..... <br /> l'lie owncr of tl�e premises is.......!%/ ���..........P'-' ��� ........... <br /> .._....._..._........._._...........___._.........................._........ <br /> 2t�c agent �s..................__......._. <br /> 'PUis nPPlir.ntion, althouE;U si�ned, sliall not Le binding uPun the City, until <br /> accep:el Uy tlie SuP�r�int�enlent af u:, R'ntm• Depnrhnent. <br /> Signed_.'..C.J '- U✓7�!/sc`c..,..._...`..... _ _...... .... ....Applicant <br /> .......... .. .... ... <br /> — . ......... .. . . ...... <br /> Accep6cd..... . _....��1....19`?.7 IIY. .� _ _. <br /> � �- / - i/Superintendent <br /> r.- <br /> uose� <br />