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: � r- <br />rt-u�' !— I'1-27-;:�_( :���.!.��_c,', <br />�r.i�.t��-�:�n� ,:on_r..r.co.—;,se-zi � . <br />City of Everett�Water Department <br />API��,ICATIOI�T FOR WATEIZ <br />All bl.ml-s must be tillyd in or erossed out <br />Cvcrett,........_..... _�/�_�" .............................102.(O. <br />PO 1'IIL SUPERINT�NUI:i1T OP THE iVATF.R DGPARTJiENT: <br />CITY OF ��'�ItI:TT: <br />I hereUy npply for the uso nf tcater in :�ccordanee wiUi the �vles and regu- <br />intions of the �'later llrp:ahuent, ior purpuses nnd fixeures slated belu�c. <br />During tiie Lime ihat any oi tl�c water m:iins may Le taken up by renson <br />at nn,y intp"ocemcrts nut}l�rized by the Citp of I'secrett, in or of �ny sLrect�or <br />:dlcy in �vhich �hcy may haee :�ecn ]nid, thc City will noL be mquired to furnish <br />�en:cr durina the P�•���ress of such imiirovemcnts to any cunsumcr whosc supply <br />m:�y tlius Le rut off, o(r�' Uc lial le for :my da�m7uges fur its failure su tr do. <br />App!icutiun No....d�-�....��........� ( � % �o , <br />�• � r <br />Eluck..... .. � 1". l.. . Lot_.. � / 2p. . ..._.._.. Add.. ___ . _ ..__.. ... <br />No. �..(% � I .- G�(y�.1.... -.....Strcet <br />_ 4 \ <br />. ..____.. _ . _. __ .. _....._.. .. .. __. .. _ .._..... ._.. <br />TLe �vork to be e: ecuted by.. .� . Plumbcr <br />f j 5'� � �,y�U• ,f.�i �r. <br />slnte s�zc ot inp. � <br />....��Z.Tri� tu be inscrted in the m�in. ;-�> ' <br />= %, <br />....... �.......\`lnter closet <br />...�._....BntL p <br />� .Ltmal � ��I � � <br />......... ' <br />... <br />._.....�...Plain fmicet insidc . •I � S d� <br />........_.:....Side a•:llc �vashcr ..� /' <br />.......�.......Ilose biU outsidc <br />.......�r::_Hose bib for buifding purpo�es <br />.....�._FIose bib inside <br />....:�...BiU for stublc containing......_............stall..._._............ <br />...._. .....NmnLcr of persons m famil}' <br />.,.J�...�_NumUer of romns in building <br />: nremises nre to be used ns i..._ _.. ���_ � ................ .. <br />. . �......�/.,..... <br />wner of the preciises is.... �.Ct'�.v��f/�5-!(t..¢r..c��jC�G_,_.� <br />.^,enC is...._....._ ...............__.................... ..._.-.._........_........_..........._.................... <br />npplica[ion, nitliough signed, aSnll not be Uinding upon tlie ity, untif <br />Uy the Super:t;ten it of thc �Pater Depnrtment. <br />Signed..... /.. .�......�/Z/�if!f..... .._ _ ......_.�.. ._.APplic t <br />Accepted....�I�.�.6.......�........1'J2(o... By ...... .. .. ............................. �. <br />— uperintendent <br />