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/��� � <br />W. D. Form ♦ <br />CITY OF EVERETT-WATER DEPARTNiENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett,....._ ..............._.:.:=._*.r,r..:.�,�.�...._........_.......19 [= %. <br />TO THE SUPERINTENDENT OF THF. WATER DEPARTN.ENT: <br />CITY OF EVERETT: <br />I hereby apply for lhe use of waler in acwrdance with Lhe rules and regu- <br />lalions of lhe Watcr Deparlmenl, for purposes and fixtures stated below. <br />During ihc lime that any ot the w•atcr mains may bc taken up bY reason <br />oC any improvemcnts aulhorixed Uy the City of Everett, in or of any street or <br />alley in which lhcy may have been ]aid, the City will not be required to furnish <br />waler during the progress ot such improvements to any consumer whose sup- <br />ply may thus be cut oft, or bc ]iable for any damages for its failure so to do. <br />> - <br />Application No.... .._l.tc�...�j:'........ <br />Block.................................._.... Lot.................._........_.......... Add...................._.............._..... <br />� �- �..J�_-.'-r�-�.n'�_..-n� .......Slrccl <br />No............(f/�'..,i.........,�... .. .... . . . ........................_. .... �, <br />The a�ork to be executed bY .......................................................................Plumber <br />Statc size of tap. <br />_-l�/.......Tap lo be inscrted in lhe main. � /� <br />....Water doset " � � b C`, <br />/.�3c...Bath �� � �ry / i �(� <br />i <br />................Urinal NOV , n: /� l; i <br />1 7 g4 � ,�=' .1 <br />. .....Plain faucet inside � <br />..�............Side walk washer CitY of F��i:.�t �L� Ni <br />................Siose bib outside w�1TE(� ,p�y�- g. � ��I <br />................I�ose bib for building purposes <br />................Eiosc bib inside <br />__.._........IIib for stablc containing.._ .............._sWll.._................ <br />. ..............NumUer of persons in family <br />.. `.........Number of rooms in building <br />Thc premises are lo be used as a ...................._....................._...__..._...................... <br />The owner a[ qic premises is......._....._......._........_.....__ .................._...........__...._.. <br />ThcaBent is .................................._._...._.............................._....._................_......_....... <br />This aoplication, although siFned, shall not bc binding upon the City, until <br />accepted by the Superi endent of �lh�e-1Waler Department. <br />Signe , . ��e1.. ._. W. �.w.� .............Applicant <br />AccePted.......................................�9....... By....................._._._.._.................................. <br />Superinlendent. <br />