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. .._. .._.._._. _ _ . _ . � <br /> , <br /> �N�i J� I-�q�Y5,9'I, . _ �-.., �i. � .�.� i. . ' . .. , <br /> \V.0.Fonn 4--luaU-E.P Co.-G:G�'L4 <br /> City of Everett^-�V�ter Department <br /> APPLICATION FOR. W.�TEI� <br /> All Ulanks nm=t Ue filled in or crossed out <br /> _ / <br /> . .......19?..... <br /> �vereit�......./.._3..�....2.5..........._.........._...... <br /> 'PO THG SUP�RINT�NDPNCITY OB EVCL CTT;��pARTV[ENT: <br /> I hereLy apply for the use of�vater in nccordmice-.���th tlie rules nnd regu- <br /> Intions of the \Vntm� Department, for purPo=es and fistm�es stnted Uelun•. <br /> During che time thnt any of the ��•atcr mains may be tnken up Ly ren.=.on <br /> uf nny imP�ovements cutl�orized Uy thc City of I'scerett, in or of any street ur <br /> nlley in �vhich they may hnce bcen Inid, lhc City ��'i�� not be requirnd to furnisli <br /> water during the PTogress of such im�uaeements to any consumer «'Lose supD�Y <br /> may thus 6e cut off, o(r�be liaqble for �ny damaSes for its fnilure so tu do. <br /> Application Nu....cT..�.�.C-:.._......._.... <br /> Ii�ock.......................................�Lot........... . <br /> .. Add................._._..._.____.._... <br /> No...�..7.��..�../.`� �'/1 .�_��........ .Street <br /> . ..................... ..................... <br />' _... .... .......... ....... <br /> . .......... . <br /> ..... .. . ........... /. ..... <br /> The work to be executed by. . - . -- - -- � -�` Flumber .� <br /> Sta�te� sizc of tnp. .��/3'fl��_ �� r/ __✓2"`_` �I <br /> s- <br /> .___�f.�_TaP to be inscrted in the main. <br /> ..._�......._\Vater closet <br /> � <br /> .._.�.........Pnd� ',. <br /> .._..7-.......Urinal , <br /> ,.,,2,........Plain fnuce6 inside <br /> .....'-......Side �vnik �cnsher � <br /> .._/...........Hosc bib outsidc '� <br /> ,.....,`_._Hose Lib for bvilding Purposes ,,,:-'� ' <br /> ; <br /> _.�:........I�Iosc biU insidc ,� / <br /> ._�:......13ib for stnUle cmdaining....................stnll......_............ � <br /> .....,.-......Number of Pcrsons in family <br /> �..........Numbcr of rooms in building � <br /> The premises arc to be uaed us n._�W._. �... <br /> .. ..��............. <br /> The owncr of the premises is.......�..,..-. .... ..C�Yi�2��t<c'............._ . <br /> Theagent is................. ................................................................................ ........... <br /> 'Cliis aPP��ention, ulthou�h signed, shall nat be bindieg apon e City, until <br /> accepted by the ScP�I•intendent uf the \Vat r Department. . <br /> � y �y- -' <br /> Signed. ....._........�Gk,�......,�!�-�...�..�) �.......APPlicant <br /> Accepted...i:�„�r....... .......192....._ BY...!u�illLf..�. .. . .lY .. `.................. ' <br /> ✓f���Atendent <br /> . __ . '�-�--� - --- ' - - — - - . _ �� <br />