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.%i �r= <br /> W.D.Form t <br /> �iTY OF EVERF.T(—�i"�ATER DEPARTMENT <br /> APPLICA'�'ION FOR WATER <br /> All blar.ks musl be filled in or crossrd out <br /> Everett�................ ...�i.Z:..-t�.r..�.���-.:..............__._.....19_�:� <br /> TO THE SUPERINTENDENT OF THE !i�ATER DEPARI'h1ENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance wilh the rules and regu- <br /> ]ations of the Natcr Depattmenl, for purposes and fixtUres stated below. <br /> During the timc that an? of the watcr mains may be taken up by rcason <br /> of any improvements aulhorized by the Ciiy of Everett, in er ot �ny strnet or <br /> alley in n•hich lhcy may have Ucen luid, ihe Cily will �wl Le t�yi�iiu� tu furnish <br /> water durmg the progress of such improvements to any consumer whose cup- <br /> ply ma} thus be c:it off, or im liablc for anS damages fot its fai]ure so to do. <br /> � a ,�i <br /> Application No. ...tt..l�........ .............. , <br /> /y / <br /> IIlock........../....c......................Lot.......��''.-.1.�..........Add..�2�l�i:-.<�.'..<�... <br /> No..........._L�'f��.........���cr!:�?'::cZr.[_�............._............Strcet <br /> ...... .................................................................._................---........................_..._...................._... <br /> The work to be executed bY...............-.-. --.-- .-........--............. ..........Plumber <br /> Sta1e sizc of tap. <br /> .:�_..Tap to be inserted in the maia I . <br /> _..............Watcr closet �1�� <br /> � A �° <br /> �:......s�th 1 D J � <br /> ................Urinal v ,f/ <br /> a4 � <br /> ....._.........Plain faucet inside rJOli� �C �j' " � ) <br /> V " <br /> ................Side walk washer v� i� �y <br /> ....._.........Iiose bib outside ��tY of Everett� H <br /> i <br /> .............._Hose bib for building purposes �WATC(� 7EPr B � <br /> ................Iiose bib inside <br /> ................Iiip for stablc conlaining....................sWll................... <br /> ......../__....Ncmbcr of persons in family <br /> ...._XL....Numbcr of rnoms in building <br /> Thc premises are to be used as a......................................................................__ _... <br /> The oancr of the Premises ia..........._..._....._.....__..._........................................__. ... <br /> TScaHent i;.._......._.........._...................._._................._..........._........_._.........._____... <br /> 'fhis applic,iiinn, although signed, chall not be binding upon the City, until <br /> accepted by thr Superinlen ent of the W ter Deparlment. <br /> M! t/ <br /> ° �. ..`.���r` ../� <br /> Sisned._�F.... ............................_................._.Applicant <br /> Arceptc'I.._ _ . . . _.. .. _ _....lp�.. ... 73y... ........ ...... .. . _......__. <br /> Superintendent. <br />