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w. o. r�� � <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be iilled in or crossed out / <br />� .1 <br />��; , � '. <br />� � <br />Everelt..............�:[ .:i._".....'._'.,r....`....:.............................19_...:.... <br />TO THE StiPERINTENDENCITY OF EVERETTDEPARTTiENT: <br />I hereby ap, Ip for the use of waler in accordance with lhe rules and regu- <br />lations of the Water P�p�rtmenl, for purposes and fixtures s[ated bclow. <br />During thc tirnc that any of thc watcr mams may Le t:,ken up L•y :cason <br />of any improvr.ments authorized by thc City of Everett, m or of any street or <br />alley in whidi �h^_y t�ay have bcen laid, thc City will not be required to furnish <br />ply may thus be ut uffsor bc liable for�any damages tor itsUf lu c so to dn. <br />Application No....! :G ./...�i..�i� ................ <br />Block ................ I.ot................................._...... Add......................................_... <br />........................ <br />C�I C � .i e <br />�..._ . ..:.,/[..r...-r...l:, c.�... �..t ........ Strcet <br />Na ................ . . .......... .. <br />............... <br />..... ........................ : ................ <br />Thc work to be executed by.. .... � 1 b r <br />. ........................_..a....... <br />........... .._.._...P um e <br />State sizc of tap. �-�� l / <br />^� // ��� 7� \\ � O P ^-- <br />_G:`......_Tap to bc inserted in lhe main. <br />................Water doset �:., ��.•�• � <br />................Balli .. /�: <br />................Urinal <br />. „ .......Plain faucet insidc <br />.. . .......Side walk washe:� / �/� �_ <br />...............liose bib outsidc �i,`_� . ,//D-�C-:r! �. <br />................Hosc Uib for building purposes *� ,� ,;: �t_, <br />� ................Iiose bib inside <br />._...._.......IIib for stablc conlainin4....-.-...........stall....._............ <br />............._ NumUer of petscros in family <br />.. _.....Number of rooms in Uuilding �-; � � <br />._.. . . ., . � i ' , . � <br />.� � ...:....:..:.................. �........_.....__................ <br />.,.,, M <br />The premises are to be used as a...... .. <br />_ ..__..__.........._..... <br />. _ .. ..................... .. . <br />The ownet ot the premises v' .............._..._....,_ <br />� ` . ._._.......__.......... <br />The aEent is ......................._..:: <br />.......... <...__...;......._........__._ ._ <br />This application, althouF>> si ed, s 11 nnt Ue binding u on the City, until <br />accepted by Lhe SuperintendeyL�o�B �t�r'�e =m — <br />Signed. ..../.C.0 � ....... /J..�...''.._....APPlicanl <br />�G .. ......v......._ . <br />A�cePled.......__...__.........._ ..............19.._... Ey......._....................SuPerintendent......... <br />