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W.D.Form I <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> r"�FLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> Fvcrcll,...__....._.. .......�Y�� '....Y..................._ _... .__.7O_ .'..�_ � <br /> TO 'f'liE SGPI�:RIKT1'sNDENT OF THE WATEP. DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use o[water in accordance with the rules and regu- <br /> ledions u[ U�e WaLer Deparlment, for purposea and fixtures stated below. <br /> During the time thal any ot the waler mains may be taken up by teason <br /> :,' anp improvcmcntc authorized by lhe City of Everelt, in or of any slreet or <br /> alley in wh;ch they may have bcen laid, the Cily wil] not be required to furnish <br /> tcat.er during ihe progress of such im;.rovemenls to any consumer whose sup- <br /> ply may thus be cut oCt, or be liable for any damages for its failure so to do. <br /> . � <br /> / : � � <br /> Applicat(ion No ....._. I� /...,,.�(rc CC � c' e� - �� [. e .1 <br /> I31ock_._.._. J�._�.. � �� .�Lot_. 1 .��f' "_✓ �......... Add... . .................... <br /> Ivo.. . :�.��...........✓..:.'.?`.:f`..:t1:<<:::tr_1�.........Streel <br /> _............. _ > 3/ <br /> .................................. ....._............................................................................................. <br /> The work to be execuicd by.......................................................................Plumbet' <br /> State size of tap. <br /> � �r <br /> _�9.........Tap lo be inserted in lhe main. <br /> _. ............Water dosel <br /> ...__.........Balh <br /> ...__.........Urina] <br /> .__._.._....Plain faucet inside <br /> _ _..._......Side walk washer , I�� <br /> __..._...Hose bib oulside �- C`��"— � <br /> .. . ._......Hose bib for building purpnaea <br /> ...Iiose bib inside /Nq, yyy���� Q� �/�`���Y <br /> ..IIib tor stable containin ..... stall..............i..s '// �� �U <br /> . g ............ <br /> _ Number of persons in family F��j� ~,s�f f� <br /> �.., . . , ;� ,,� <br /> . . . _.......Number ot rooms in building -. . ��� . <br /> 7'hc premises are to be used as e..........................................._.......:........................... <br /> 7-l�c owner of the premises is.................._.................................................................... <br /> T':��� agent is...................................................................................................................... <br /> 7'h:s application, nithough signed, shall not be binding upon the Cfty,until <br /> y ' J��f th �Water Dep(artment. <br /> ;ircrnt�.�:l U tS BS d-f...�e�.�.fh.�.t.o..c._�l�l.�'y�.,k�V-- ..........ApplScant <br /> .....'`--.:......... <br /> Accepted............................................19....... HY.................................................................... <br /> Superintendent. �I <br /> a <br />