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` ' . <br /> i� ' <br /> W. D. Foim 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> I All blanks must be filled in or crossed out <br />� <br />, <br /> Evcrett,.........__........__.....11�'....�_:.�:...-:...�...._ ......19�r.`!.. <br /> TO TfiE SUPERINTENDENT OF THE WATSR DEPARTDIENT: <br /> CITY OF EVEREI'T: <br /> I hercU�� apply for the use of water in accorda.i;c with tFc rules and regu- <br /> I 1:iHons of the R'aler Department, tor pm�poses and [�xb.�r�s _t�tcd bclow. <br /> Uuring thc limc thal any of the watcr main, rna�� i,� tal,�� up Up rcason <br /> o[ any improvemmts authorized Uy tlic City ot Evcrett, in ^�r •: am� strect or <br /> alley in which they moy h;�ve Ucen ]aid, the City n�ill not he r red �� turnish <br /> waler durin�; the progress ot such improvements to any c�na ^r whose sup- <br />� ply may thus be cut off, or Ue liable tor any damages for i: a.lure so lo do. <br /> Applic�tion No/�::l.L-.,C.................. ' <br /> I31ock.. ....._.............................. LoL._......................__.......... 4dd.._...... ............................... <br /> , � �� . <br />, � No.......-::'..,i'...I../ .....:L.'_c-�,:�.C.,a..:..-,f - �` ••. i:l.:��.a��c a[rcet <br /> ................. ... <br />[� <br />. ............._............................................................................................................_....._.................. <br />� The work to Uc execuled by...........................__....._...._.........._.. .... ...._.Plumber <br />� � St�a��,/sizc of tap. <br /> I� ../�.�......Tap to be inserted in thc main. <br />� . ........._.....�Vatcr doset t-� i' <br /> t . ................IIath � Rl1 � P�*f-"7 �1�I <br /> ii�'� : � ............ ..Urinal /f• ,(Y � � � <br />' � ' <br /> ...._..........Plain faucet insidc A,�q ���4/L J - <br /> {� ! G <br /> .....__.......Side walk washer d <br /> I '�� ................Hose bib outsidc Ci1y Ot LV�fCtt <br />: ................Hosc bib for Uuilding pw�poses yVATER DEP_r.. ��, <br /> 1 ................Flnsc bib inside <br />� _..............Dib for stablc containir g. ...._.....__..stalL................... <br /> .._..__.__.NumUcr of persons in family , <br /> II ................Numbcr of rooms in building . <br /> I: � Thr Premises are to Uc used as a................_...._...._.............._._............._................ . I <br /> Thc o�vncr of thc Premises ic..._..__._._...._ ....._.._._....._............__........................... � <br /> li, TSc aBmt is.......__.............._...._. ._..............._......._.................._..__.............__........... <br /> I This application, althnu�h signed, =hal] not be binding upon the City, until <br /> ;mcepted by the Surcrin endent�f the 1Va Department. <br /> � _ , N <br /> C�_�^(F.,.;��.k._...= c a. . <br /> Si�necin,.r f . ..........._..._.._._...._....__...._.Applicant <br /> � Acccp'c�L . . . . �.. ... _ .. 1".__.. Bt� . .__._.. <br /> ..__...._ __._..........._._. <br /> Superintendent. <br />� <br />