Laserfiche WebLink
�_�/ � <br /> i•l <br /> W.D. Form 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> /.:%� ,./� <br /> Everett,_......................... ....��i......................................1'J4.;._!.— <br /> TO TFIE SUPERINTENDF.NCIT�Y OF EVERE T DEPARTMENT: <br /> I hereby apply for [he use of water in accordance witf� lhe rules and regu- <br /> lalions o[ the Wntcr Depa:tmcnt, for purposes and [ixlures stated below. <br /> During L�e time Ihat any of the watcr tnains may be taken up bY reason <br /> of any impro�'ements aulhorized UY lhc City of Everett, in or of nny strcet or <br /> allcy in wLi.•� they may have bcen laid, lhe City will not be required to furnish � <br /> plytmayUthus�te eurt o[tsor bculiable�por�anyedamages for�tsufa'lurc�so to do. <br /> Application No........_:.'�✓....�.1'.............. <br /> Block................................... I.ot......................._............... Add........._.__........................... <br /> ..../ <br /> �J'� j ,T -G+-.r.c.�� _....._..Strcet <br /> N o...............-�................... ...,... ... .................................... <br /> ...................................................................................................................................................... <br /> The work to be executed b . .._.......PlumUcr <br /> y.......................................................... <br /> Stale size ot tap. , <br /> . .�� A. <br /> �....Tap to be inscrted in lhe main. �ZJ <br /> . .....Water doset � � /� <br /> �../1�...Balh i` <br /> _..............Urinal J�,r,� A ..��✓ i i <br /> ................Plain faucet insidc � C�(y� . �✓� �J .? <br /> ._.............Sidc walk washcr '9TF `r.` � � � .� <br /> ................Hose bib outsicic RO��/\ �(� (�'�� I <br /> . �� �� <br /> ................Hose bib for buildin6 Purposes �j - <br /> ................Hosc bib inside '' <br /> ................Bib for stat�lc containing...................stall.................... <br /> ...............N::��bcr of persons in family <br /> ._�'.......iQumUcr of rooms in building. <br /> The premises are lo be used as a......._........._......_................_... ._._...... ........._...... <br /> Thc owncr of thc premises is.......................__..........._........._......_......._...... ._.__..... <br /> r;,� agent is...................._............_.....................................................................__....._. <br /> This application, althouFh signed, shall not be binding upon the City, until <br /> accepted by the Superinlendent of�thC �yater Department. <br /> � ' `�?'�r-.tc',..-""rp...........A licant <br /> Signed..�I�.�....., . .��......� .�..... PP � <br /> �..... <br /> Accepted.................._.................___1P....... BY................................�............................... <br /> Superintendent. <br /> --ti — <br />