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� <br /> , �- � �- � <br /> W.D. Form S <br /> CITY OF EVERETT—WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must bc filled in or crassed out <br /> ,�, J ✓ <br /> Everett..................__........:................................................19�::..1./ <br /> TO THE SUPERINTENDENl' OF THE NATER DEPARTn4ENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance wilh lhe rules and regu- <br /> lalions of the \Vater Department, for purposes and fixtures stated below. <br /> During t}�c timr. that any of the water mains may be taken up by reasou <br /> of any improvements authorized bv thc City of Everett, in or of any slrect or <br /> allcy in which thcy may have becn�laid, the City will not be required to furnish <br /> water during the progress ot such improvemenls to any consumer whose sup- <br /> ply may thus be cut off, or be liable for any damages [or its failure so to do. <br /> Application No....f_f�...�� � .— <br /> ..................._� . , <br /> -C c-:t �' C.�_C,���</ <br /> Hlock........................................Lot.....,,.�....,....................... And..............;............................ <br /> ' ( /r- / <br /> N0.................:�_�...�...�.........i....�.z...f.t.C...�::7:Z..:G..G.:S..6.`..cF.....s�[CCf <br /> ....................................................................................................................._............................... <br /> � The work to Ue creculed t}•.......................................................................Plumber <br /> �Stalc sizc of tap. <br /> -= !�.........Tap lo be inscrled in the main. . <br /> Y...,.......Natcr closet �(L i ct . �_. . � <br /> L: � <br /> 1.........s�cn li � r'':':�-- <br /> .... . <br /> ................Urinal a r-, _ �- . <br /> ,,. -y ;; <br /> ................Plain faucet insidc ' . <br /> ................Sidc tvalk wasl�er <br /> _. ., . <br /> ................Hose bib outside �, � -� <br /> ................Hose bib for building purposes . _ <br /> ................Hosc bib inside <br /> ................Bib for stablc containing......_......._._st�11�.........__. ._.. <br /> ........_._.Numbcr of persons in fami]y <br /> ..��..'.....Nwnfier uf rooms in Uuilding <br /> Thc premises are lo bc used as a........_.__.._ _. . . ..._. _._... __ ._ .. _.. .. ... _ ._... <br /> Thc owner of thc Premises is..................__. ...................__......._.. ..... ....___..._._..._ �. <br /> Thcagent is...................................................................................................................... <br /> This applic�tion, although signed, s+a11 not 6c binding upon thc City, until <br /> accepted by thc $.upeCintendenl of he�Valer DeP,ar ent. � - <br /> J J : . <br /> . . <br /> -'S��ned.......G..��../ ' , .� ��-. <br /> . ,._.....__......�L............_.........................._Applicant <br /> Accepted................_.........................1�....... II}•........._...._................._...................._.......... <br /> Superintendent. <br /> "�C-r: - <br />