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, �. i / ^ - <br />W. 1�. Farm 4 � <br />CITY OF EVERETT-WATER DEPARTMENT <br />AFPLICATION FOR ��"A'TER <br />All blanks must bc filled in or r.rossed out <br />F.vcrctt,.._....._ � � . <br />T'O TfIE SUP�RIN7'ENDENCITY OF F.V AT R DEPA ����� <br />R1'B1ENT: <br />ERETT: <br />I hcreby apply for the use u[ vin(er in accurdancc with the rWes and regu- <br />lalions ai the Water Department, Ior purposes and tixtures stated bclow. <br />During the time that nny af the watcr mains moy bc taken uP ��y rcason <br />ot any improvements aWhnrized bv the City o( Everetl, in or ot any sirect or <br />����Y in which thcy may Fcivc been�lnid, the Cily will not be required to turnish <br />waler �lurin�; the progress of such improvements to any consumer whosc sup- <br />P�Y �%., thus bc cut oC(, or bc liablc tor any damages tor its failure so to do. <br />APPlication No...... �.1_..%... J <br />- �1... ........ <br />Block..._..._..._...___...._._...._ Lot . ..___ . <br />....... Add...._.. <br />_. . _.___._.. __. <br />No. . .. _..._.... i_ .: �. [ . <br />�% G...._�%�t� �4t..s c ....._. Slrcet <br />.... . .. ...... <br />... <br />.. .... .. ......... <br />The work to bc execuled by .. ...... <br />_. _ . . _.. _. . ..... .. ._....Plumbcr <br />Slatc sizc of tnp, <br />.-.--..-..-9'ap tu be inserted in thc main. <br />-���-����-.....�Vatcr closet <br />� � � � � � <br />....._.........Bath � ��4't J[ t <br />..........._._Urinnl ��/`� �i-t/� <br />--�- ��......Plain faucet insidc ' <br />-..-.--.._.Sidc walk washer / '. �/ <br />-..._._...Ilosc bib out�idc (�C) "�.�./-«-«c� ���/� c_ <br />...-......_.Hosebibforbuildin6perposc�(Q.�„<!,� �%tic�.,�I,��,�,,� <br />� --� --�--._Ilosc bib insidc / <br />-- -- �-....,IIib tor stablc containing......_......._..stall__. <br />......_. .. <br />�-�� �._Numbcr of persons in family • i� t 4. <br />...--.-..Numbcr o[ rooms in building G' ,: !-� ii. r �� �,�//9 <br />The premises are lo be uscd as a_.... ......_._._ �! �% jC �: �.."a�.[ <br />_ <br />The o�ener ot the premises is.__....__._. ................. ...... ....... <br />___ <br />_. <br />,ic agenl is.........__._ � __. ._. . .. <br />. . _. ...._... <br />.. . _. ._.__. ...._.._... <br />T�115 �PD�ic.itinn, :ilthough si�ned, shall not bc binding upon thc City, until <br />:�cceptcd bp the Superintondent n[ Ihe R'nter Department. <br />SiFned <br />__. <br />.._.... . . ._. _ APPlican <br />A�.vi pti��l �n <br />Rv <br />SUPci mlendcni. ._. <br />