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' „ <br /> W.U. Foem 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks mnst be tilled in or crossed out <br /> Evcrclt�........__..._......._..._�...=�..�..;:....�.�i.................19 k:_��.' <br /> TO TIiE SUPEI4INTENDENCITY OF EVER TTDEPARTMENT: <br /> I hereby apply for the use of �vater in accordance with the rules and regu- <br /> l:�tions o[ the Natcr Depa��ment, for purposes and :�.xtures stated Uelow. <br /> During ihe Lime tL�l ar.� �i thz �vatcr mams map bc laken up Uy reason <br /> o; any improvements au:'.:^r'zed l) thc City of Everell, in or of any strecl or <br /> allcy in which they may hace be�u :' J, the Cit�•�eill not bc required to furnish <br /> �v:der ducinF thc proFress of s�.uh � �rov?ments lo am• ronsumer �vhose sup- <br /> ply may thus bc cut o[f, or be 1�:.. � .or an�• damo8cs fur its t:�ilure so lo do. <br /> ' i.. <br /> Applicalion No.....:...f:..........�... . _....... <br /> Block_......... ......Lot....... ..._.. _.. ...._.._. Add.. _. ... ._.... .___. <br /> . No...._.:..�. ....�.. .'_ r' � - — _.._.Sltcet <br /> � <br /> .:.c. �.-_............_........._.......... <br /> _ ...�:....:............ <br /> _ ..................................__............... _..................................._.................._......._..... <br /> 'Phe wock to be executed by... .........._._._ . . . . . . _ . . . . . .. . _ . .. 1'lumbcr <br /> Statc size of lap. <br /> i <br /> _ �:-.�.F.�.Tap to Ue inserled in thr. main. <br /> _. .....�Valer closet <br /> 1 <br /> _.._..........Bath . " . <br /> ___.._......Urinal <br /> .._.. .........Plain faucet inside ' ��� � <br /> ...._......Sidc walk w:;siicr , `(`� � �� <br /> .. .........._Hosc bib outsidc �` . � � , ''� � , , <br /> .,, <br /> ._.........Hosc Uib for building pw�poses'-. <br /> .___ .....?Iosc bib inside <br /> .._............BiU for slablc containing._..........._.._st;�❑.. . __. .. . <br /> � ._ . ._....Number of persons in family <br /> . ._._..Nim�bcr of romns in building <br /> 'Pim premises arc to be uscd as a......._.........._._.__.........._. ._ . . __ . ._ . ... <br /> 'i he owner of lhe Premiscs is...._._........__ .. _......__._...._......_........... <br /> . . ....._.... ...._..... <br /> 'P;ic agcnt is........._......._............___. _.... .. _ _....................__.._.....................___... <br /> _.. . <br /> 'i'his appiication, .lthouCh siF���� ���^�� not Uc binding upon the City, until <br /> :icecpted Uy the Superintend� en of the \'Vater Deparlment. <br /> � <br /> Sicned:,..__��.1�C...4s:,�.._.....�...��.C'.:K��:.�........__.__.......ApDlicant <br /> - A��t'rp:rd. .. . . ._ . .. . ..1!!.. _ Ap ..... __. .. . . .. ._._..__... <br /> � tiuperintcnd��nt. <br />