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W. D. Form •� <br />CITY OF EVF.RETT--V4'ATER DEPARTMENT <br />APPLICATION FOR '�'JATEFt <br />All blanks must be filled in or crossed out � <br />Everett,........".. J... 1Z:='N...l....I ....................--............19......... <br />/ <br />TO THE SUPERINTENDENT OF THE �yATER DEPAR7MENT: <br />CITY OF EVERETT: <br />I hereby apply for the use ot water in accordance with the rules and regu- <br />lations of the Water Deparlment, fnr purposes and fixtures stated below. <br />During the timc that any of the waler mams may be taken up by reason <br />of any improvements autho:izr.d by the City of Evcrett, in or of any strcet or <br />allcy in which they mny have been laid, the City will not be required to furnish <br />water during the progress of such improvements to any consumer whuse sup- <br />ply may thus be cut off, or be 1iu61e for any damages for its failure so to Qo. <br />AFplication No......�. � F..l=-�........... <br />Thc work to be executed by ...................... <br />State size of tap. <br />...L. ��....Tap to be insm�ted in the main. <br />................Nalcr daset <br />.....Plumber <br />�� � � <br />� <br />................Bath �i��� � d�/G.: <br />................Urinal �� � % <br />................Plain faucet insidc '; / � . � <br />................Side walk washer ."'� ��__ (- ..• . � �� -'� .% -. , �:'- <br />�, <br />................Hose bib outsidc � /�/-� � ,i � <br />................Hosc bib for building purposes —{�- f f�rn r`� <br />................Hos;: bib inside ' r! <br />................Bib for stable containing....................stall.................... <br />................Numbcr o[ persons in family <br />...............Numbcr ot rooms in Uuilding ., . � <br />i:l„ -'" <br />Thc Premises arc la be used as a..........' .:....:......�.U............................................ <br />The owner ot !he premises is......._ ............._................................................................ <br />T;�e aBent is .........................................................................................:........................... <br />Tliis application, altho � x�ign _ ot be binding upon the City, until <br />accepted by lhe Su ' c� of the er Department. <br />✓� SiS ` .............. .i�l._....................................................APAlicanl <br />AccePted............................................1�....... By.................................................................... <br />Superintendent. <br />