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W. D. imm a <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />A'i blanks mur.t bc tillcd in or crossed out <br />Evcrclt.. . _. . . .... .:. _ ._ .. . _...19:..�:. <br />Tc> '1'IIIZ 51'I'F:I;Iti'1'F.NDENT OF TIIE WATF:It DE:PAATMENT: <br />CITY OF EVF.RETT: <br />1 irercby npplp (or lhc usr uf �vntor in nn���rd;mcc u�ith thc rules and regu- <br />iau�ms nf Lhe Water Uepnrlment. fnr pw�peres nncl fixlures slnted belotv. <br />DurinF ���� Limr ihal nny nf thc ��•atcr mains may 6c taken up by rcason <br />��f ;my improt�rmenls �ulhnrizcd by �hr Cily of F.vrrett. in or a( nny street ar <br />all.•y in tvhich lhey may have bren Inid. the Cily �vill nnt bc rrquired tn furnish <br />�c:ilor durinF ����' progress of such improvements tt� nny consumer whose Sup- <br />pl�� may thus bc cut of(, or bc liablc for nny dmm�ges fur its fnilure so to do. <br />Applicntion No._ '._..'.. .. ' ........ <br />❑Inck � ' �� _._._. Lol .. . <br />. -:.�.....:... .... . . <br />_ .— <br />v�� __ _ _. . . <br />. .._.Add....._...-.. .�..� .".. <br />___....._.....__... . Slrcrl <br />.................._..._ . _._..._._._......................................._._._. . ...___......... <br />'Phr �vork lo be executed b��. . ... _ _.... . . ... _ _._ . Plumher <br />tit:�i�• siu ot tap. .. <br />. T:ip �0 6r inscrled in lhe main , <br />.Watcr c9nset �t � " <br />..Balh �e'����y.���: � ��� <br />_Urin�il pa , � � . <br />..Plnin fnuret insidc r�� �.il <br />��4 v �� f / <br />..Sidc tvalk wachcr <br />llncc bib oulsidc � ; ` � <br />..ilnsc bib fnr buildin ��� J <br />F nurposes _ a D':ti' � � <br />.Ilose bib insidc "��n+F:,� <br />..I3ib tor sle�blc containinF-..-..-.-.-. .91n❑.. .. ..._. ... <br />Number o[ persnns in family. <br />Num6rr nf moms in Uuilding <br />.�.I�.� prrmises nrc la br uscd a; n... . . . <br />'I'h�� ou•ncr u[ lhc premiscs is _. . . . . . <br />'1'hc agenl is. _ . . _ . .. . .. . . . . . . . .... <br />'I'hix nppliratiun. ;JthouF!h =ignrd. sholl nnl b�� bindinF ��P��n thc Cil)', imlil <br />:�r;�optcd Uy qic Suporintrndi�nt nf lhr \Pntcr Deportinenl. <br />Ricnrd . . . ;• .... . �� �._� .� . .r. _ _ Applicant <br />I � .\....��.��'i� � in. IS}' . ._. <br />�up�•rintrndi�n�. <br />� <br />