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' _ ... <br /> .�,'«' i. , <br /> W.D. Fo�m 4 <br /> CITY OF EVERETT—WATER GcPARTMENT <br /> APPLICATION FOR WATER <br /> �' All blanks must be filled in or crossed out <br /> Everett.................................Ic�..-:.G..::�..........................19_.�::'...' <br /> TO THE SUPERINTENDENT OF THE NATER DEPART\4ENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules and reFu- <br /> lations of the �Vater Lepartment, for purposes and fistures slated Uclow. <br /> During the lime that any of the water mains may bc taken up Uy rca�on <br /> of Sny improvemenls aulhorized by the Cily of Everett, in ur ot any strect or <br /> allcy in which thcy tnny l�ave 6een]aid, lhe City tvill not be required to furnish <br /> water during the progress af such improvements lo any consumer whose sup- <br /> ply may thus be cut of[, or bc liuble for any damages for its failure so to do. <br /> • , - -�iv" �- - � <br /> Application No.....L...r...._:.._!.................. _.C-� ,� �. <br /> �..t � �:.;•--- <br /> . ._ - <br /> Btock.......................................Lot.................:'..�.............. Add:,..:<s...-_.:..c:.r_�`r._:��� - <br /> / �' . . <br /> : ' . ^:-� � i , � ., i <br /> rro......................:r:...-.....:.:..............-:.,.-.... ...�.......c_.:-::.,.:,.:.��<��:.:siTecc <br /> ✓ <br /> _ _.._.......................................................................................................................................... <br /> 'Phe work lo Ue executed by........................_..._........................................PlumUcr <br /> S�atc sizc of tap. <br /> _�"......_Tap to Ue inserted in lhc main. <br /> ................Water closet �� `/� � C, <br /> ' . r f� , � . <br /> ................IIath ��' <br /> ................Urinal . , ; <br /> . G. ;�,� , <br /> ................Plain tat!ret insidc �.•'.;i `� � /. <br /> ., .. <br /> ................Side tvalk �vashcr �.. ; ,-�` -`:. ' �/ <br /> . �1�_. <br /> .. ................Hose bib outside �,.. - _., ;.._._' . <br /> . . ..li���.:.:r,r <br /> ................Hose bib for building purposes <br /> ................fiose bib insidc <br /> . ................Bib for stable containing...................stall.�.........._�, <br /> ................NumUer of Persons in Samily ., `�r ----�_,,,l�._ ...,:..� <br /> i.. i�_(.:.,�.� /ii� .. . �- � ,. <br /> ............._Num6cr of rooms in Uuilding ' ; /� <br /> �'� f /t���-�*",..,.r;. -/ <br /> The premises are to be used as n....................:mr....�..�..... ........................._.,.C.. <br /> The owncr ot thc premises is......................_.�c.:.C.�:.+:�G.�lr�.�.�.-...........��_::�__.. <br /> Thcagent is.............................._............................................................................._�...... <br /> Si�ned_..:.� �signed, shall no bindin upon the City, until <br /> pP 6 nl�qf the Wate Departme . � <br /> e \ <br /> T us a ication, a ioug <br /> accepted by the Superinten o <br /> i <br /> /�� ,•.7 <br /> • :.�L[:.G,c.._�..:.... ..��"� L.'.._.1:../......._.ApPlicant <br /> r...�, <br /> , , <br /> n���,�;�a _ __ _ _.._....�s..._.. sy -. _...._..... <br /> Supermlendent. <br />