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--1 <br /> I <br /> I <br /> �� ��_--,�, <br /> W.D.Form t <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> Everett,._......__._ 1..-r_l��.. ..._...._ .........._......19�.�. <br /> �. . . . . .. .. <br /> T7 THE SUFERINTENDENT OF THE�WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hcrcby apply for the use of water in accordnnce wilh the ru]es and regu- <br /> lalions of the Waler DePartment, for yarposes and fixtures slated below. <br /> During lhc limc that any ot thc watcr mams may Uc taken uP by rcason <br /> of any improvements authorizcd by thc City of Everelt, in or of any street,or <br /> allcy in which thcy may have been laid, lhc Cily will not bc required to furmsh <br /> waler during the progress of such improvements to any consumer whose sup• <br /> ply may thus bc cut off, or bc liablc for any damages for its failure so lo do. <br /> Application No......lV�.�.� . . <br /> w�....... , , <br /> Blocl��..',�./�..:.�?�.���Lol.._....._.......�-lf�G`dd.�_..............._.._............. <br /> No...._..........Y"...✓�...__�.4_.................._�........--.Slrccl <br /> _..._....................._................__.._...........--'--.........._..........................._.._......................._......... <br /> Thc work to be executed bY_....._........_._..._.....__......._.........._.._...._.._Plumber <br /> Statc sizc of tap. • <br /> � (Y�-�C,[�2-C� <br /> f�..'..�......Tap lo be inserled in the main. <br /> ................Water closet i . <br /> ...............Bath � /J� <br /> ...............Urinal ,,,"/� �� ,� �C;(� °%- <br /> .....Plain faucet insidc � �,/� <br /> . � . :-a.�{ 7L� <br /> ................Sidc walk washer � � <br /> ..._....._.....Hose bib outside ���3, <br /> ................Iiosc bib for bvilding purposes <br /> ................liose bib insidc <br /> ......_._.....IIiU tor stablc conlaining......._...........stall.........._._.... <br /> ........._.....Numbcr of persons in fami]y �" �..�rc a.�.Z � <br /> .___._......Number of rooms in building <br /> � The Premises nrc lo Uc used ns a......_............_...._...._...__........._..........._ _........... <br /> The awner of lhc premises is....._.._._....._.._.........__.....__...._..... ..___.....__..._...... <br /> The agmt is.._. . . .... _ . .. ..___... .. ......._._. .............. ........._._.. . -. �,6"•- <br /> �o i <br /> This applicalion, although s�gned shall not be bindmK upon the City, until �� �I� ��.�j :ii <br /> accepted by lhe Superinlendent of the Wale Deparlm1 t . I � <br /> AccePted .Signed .�'�.�:�9 f.-....$�.yL"' ' �� F�..�v ��..._APPlicant . ' r �n��'L'��`.''I .����� <br /> Supenntendent. � _ _� �i�, ,� <br /> ,� ` ��tiho <br />