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�' . �� r�T. �� I'� I1��1.:-f�.11. <br />' {1�.�1 �'OM1lli--lup�l--ti.T'.�0.-G.:G21, <br />City of Everett��ater Depat�tme: ' <br />AP�'LICATION FOR �AT��R <br />:lll Ulnnks mc=t Le f:ilyd in or cros=ed aut � <br />i�/ y_/:...y.._ ..... ................��2..... <br />r�•� r� cc,....... . .. .1... . <br />PO THli SUPCRINTENDF.Ni OR THL: �4ATP�R DEPARTI[r:ti'C: <br />CITY OI' �VEI;GTT: <br />I hereLy :ipn�s' iur the �ue of w�ter ;n accm�d:,nce with the rules and icgu- <br />lations of thc R'uter UcparLnent, for pw�puses and fis�.m�es stated belc�v. <br />llurin� ihc time that :nty of thc �rnter mains N�iy be ta���� uP Uy rca�un <br />o[ nny imPru.ement;, autlmrizc� by !he City of Ee�rett, in or �f tmy strcet or <br />alle}• in whirh �hcy may hnvc hcen laid, the City ��'ill nut 6e te�uired to furnish <br />water dm'ing the pivgress of �nch in�q�rocemcnLs to nnp cnnsumer wl�ose suppl}' <br />�u::y thus 6c ctd of[, or be IiaLle fw• :iuy damuges for its I:iilure sa to do. <br />Application Yo...,3.��:�- :............... <br />� <br />blo�lc ..... �� ' I.ot.... . ...__.. ........ Add. .._ . ._... ..._. .. _. <br />/.... <br />Nu..�..SB � ���0 /� .�...�..I� �.Street <br />__._._. . _.__.._... .........__._. . ........._.. . .____ _ _ . .... <br />The «•ork to be e�:ecuted Ug.__..._......... <br />St�tc size of tap. ' <br />................Tap to Ue inserted in ihe mcin. <br />__. _.......�Ciitcr closet <br />..._....._....I?n[h <br />. ............ _uTsnn, <br />...............Plain f:mect insidc <br />.._. _...._.S:de wallc a'nshcr <br />...._..........Hn�e bib oulside <br />._._._.......Ho�e biU for 6uilding p�rpoacs <br />...__ . _. ... ._.._.... ......Plumber <br />t�p �/ � <br />� � ! �w� v ` �/— � � <br />3�� �� �ti��L�'�i�1�{.�..<<- <br />� � �� " <br />� ��� • a •��� 6y <br />� � <br />.__...........Ilose b�b viside :� <br />................Bib for stnLle contaiuin�....._......._.._�ta:L............_�r; i .'. <br />r <br />......_........NumUer of persons in fnmily <br />...._..._.....RumUcr of rooms in building l, . <br />Thc premises are to Le used ns a..__._.. __._ ... ___. _......���...... <br />. _.. .. _.. _.......... <br />'1'Ue owner nf the premises is........._... __.......... .._. _... ___ ............. <br />............ _ _... . <br />The agent is.....__ ........................._.................__....................__.................... <br />._......._.... <br />Thie applicntion, altlmu�h signed, shall not bc Uinding ulion tLc City, until <br />uccepted Uy the Superint�ndcnt oC lt�c Na?cr Depar[ment. <br />�i4Cned�✓.�...K.—���.l......_. ._...._. pl�cant <br />1•�•cp.:,... ..1�.....L�� -19c/- Uy._ `/ .�,�1, � <br />. ...... ......_....... <br />ntcndent <br />