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W. D. Form ♦ / l ; l � . : ! '' i `i (,�, <br />CIT� OF EVEitETT-WATER DEPARYMENT i <br />APPLICATION FOR WATER <br />All blanks rrust be filled in or crossed out <br />� <br />,�'� . r ; f,�� <br />Everelt ....................::..:.. :. _::...::..... ........ _.. _.....................19 �......-... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTME?IT: <br />CITY OF EVERETT: <br />I heteby apply tor the use of water in accordance with lhe rules and regu- <br />]ations o[ the Water Department, for pm•poses and fixtures staled below. <br />During lhc time lhat any o[ lhe watcr mains rtnay be taken up by rcason <br />of any improvements aulhorized Uy the City ot Everett, in or of any street or <br />alley in which they may have bcen laid, thc City will not be required to furnish <br />water during the progress of such improvements to any wnsumer wl�ose sup- <br />pIy may thus be cut off, or bc liable for any damages for it Sailure so to do. <br />/ � '"r'��i <br />Application No....�. �.:�'�� `?� �r' � - ' <br />....................�� L � _. <br />Block.......................................: �I.ot........................................ Add........................................... <br />,J / <br />No........_ �/-:.�i.._�.�.. .. �t..t.:�:�.:a.�: .-s�:�::.:.:..`. ::.^:5.� .........................Street <br />The work to be execuled <br />State sizc of tap. <br />..../u <br />.........Tap to be inscrted in the main. <br />................tVater closet <br />................Balh . . <br />� � r <br />................IIfinal � . �; <br />n, � <br />................Plain faucet lnside � �� ,� �`. �(/ <br />................Side walk washer / � .� <br />................Hose bib outsidc l�% G n � <br />................Hose bib for building purposes n �,�r,�' <br />................Hose bib inside ��%',-�� ,,4 <br />g ...................stall................ � � <br />............._.IIib for stablc containin � <br />................Numbcr of persona in family <br />................Number of rooms in building, � f�' / �_ <br />Thc premises are to be uaed as a....:��..� L`-�—Y'✓�'`�T�J ,� '�+` � <br />, ,� �. <br />The owner of the premises is.._��- ( :, �� ( .F.'-i � � �P <.+.�y . <. <br />� .. <br />TSeagent is...._....._ ..................................�..............._...._............._........................... . <br />This application, a]thou�h cigned, shalt not Ue binding upon the City, until <br />accepted by the Super' ndent of thc Watcr Depar ment. <br />SiGned:..�.%... .�.. ,�...�/... ..... . ...... ... . . ..............Applicant <br />� <br />Accep:c:l..__...__.__..._..._._............10....... Ay .................................................................... <br />Superintendent. <br />