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_ �� Ls� <br /> w.o.��m a <br /> CiTY OF �VERETT--WATER DEPARTMENT <br /> AFPL,ZCATiON� FOR '�%ATER <br /> All blanks must be Llled in or ciossed oul <br /> Svetett,......._....... �....:.:._�.�..................................19�:.v <br /> TO THE SUPERINTENDENT OF THi: WATER DEPART➢1ENT: <br /> CITY OF LVERETT: <br /> I hereby apply for the use of water in accordance with the rules and regu- <br /> lalions of the 1Vatcr DePariment, tor purposes and fixtures slated below. <br /> During thc timc lhat any o[ the watcr mains may bc taken up by rcason <br /> ot any improvements aulhorized by thc City of Evcrclt, in or oi any strcet or <br /> alley in which t'ncy may have been lair, the City will not bc required to furnish <br /> walc�r durin� tSc Froeress of such improvemenls to any consumer whose sup- <br /> ply tnay lhus be c��t off, or be liablc Sor any damages for its failure so to do. <br /> �• �� G <br /> Applicatinn No... .�............ .._......_....... <br /> Block........................................ Lnl.................. A/y/d........................................... <br /> -� .. � . ��2_;<...�K-C[,:�i...Strect <br /> No............................ ... �:........,,......._._.__............... <br /> �_�....,... � <br /> ................................................................................................................................................. <br /> The work lo Ue exer.utrd by... ._..............__..............__._...................._....P1umUer <br /> State size ot tap. <br /> ..._...........Tap to be inserted in the main. ���> <br /> .. Water doset ��(��(_,, �.j�(t���/' <br /> Bath �� <br /> .............._Urinal /��."�,Qiyr'�G� <br /> ................Ylain faucet insidc 'L^ <br /> ................F.i�e w21k �vashcr <br /> .............._flose bib outsidc J�d � `'�! ,,,� <br /> S(J. <br /> ................Hose bib for building purpose� �•-„���/ <br /> ..........._..Eiose bib inside . /, . �}.�;,� � <br /> ................Bib for stable containing....................stall................._.�/� ' /�7 .. <br /> �' S <br /> ................Number of perscns in family <br /> ..... .... ..Numbcr ot rooms ]n building <br /> T e Premises are lo be used as a................................................................................ <br /> Thcowner of the premises is.................. ................................................_..........__..... <br /> Theagent is..........................._......_...._.....__..............._........._..................................... <br /> This application, althou�h signed, shall not be binding unon the City, until <br /> � ndcnt of the Water Deparlment. <br /> aae ted b thc Su crinte I/ ^ r <br /> ' P Y /" .� <br /> ' ./�..r.:.J.:2'..._..:�......�+:�7�..Z.f:..�!,.�..Q..1:.....................Applicnnt <br /> AccePted............................................lE,...... Hy.................................................................... <br /> Superintendent. <br />