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_ , . /.-.. <br /> W.0. Foim 6 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATIOI�T FO�R WATER <br /> All blanks must bc filled in or crossed out <br /> Evcrett,....._......... ...`., � � �/ ........_.....19�'`/. <br /> .. ......_-..............._._... <br /> TO TfIE SUYI:RINTENDENT OF THE WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordanee with the rules �nd regu- <br /> lalions of the �Valer Department, for purposes and fixtutes stated below. <br /> During thc timc that any of the watcr mmns may bc taken up Uy rcason <br /> ot an}• improvements authorized by thc City of Evcret[, in or of any street or <br /> ❑Iley in �chich they may have been laid, the City will not be required to Lurnish <br /> �vatcr during thc progress ot such improvements to any consumer whose sup- <br /> ply may thus bc cut of', or be liable/for any damages for its failure so to do. <br /> � fD' � G.J _.�r,. .�� l! if.,. <br /> Application No.......................... _............ . <br /> i � �, -. <br /> ................. ' ,........./.. �..._..._............... <br /> Block....................... Lot...!✓..........aQ Add....-:..'-..�'> <br /> No......_.. ..`_.;..�..-:..............�....�_�............7�.::.`.��,-.............Strcet <br /> ...................................................................................................................................................... <br /> Tlie work to Ue executed by.......................................................................Plumber <br /> � i <br /> Slatc sizc of tap. S O� ' <br /> .. ...._.._...Tap to be inscrted in !he main. ..� , <br /> ,. ,. . � <br /> .__...........�Vatcr closet � ,�% .�. �. , �•` r � <br /> . __........Bath . ,� Y �/ y <br /> L� <br /> _..............urinat ,. ..��. <br /> ..._.. ...._..Plain faucet inside - � ' �' � <br /> .....Side walk washer /f <br /> ...._....._....I3ose bib outsidc �L.�""-l(�J�.-�t� <br /> ._....._......Hosc bib for building purposes '� <br /> .__.........Edose bib insidc - � <br /> � ;.�;, l/� � '�. � •,l �/Uti: ��. <br /> ..._..........Bib for stablc mntainin stall..............%.. i, . - . <br /> g.................... J , <br /> ! J }� % " f d ' / <br /> ._..._.......Number o[ persons in familp , �_ " <br /> ..._...........Numbcr of rooms in building � [c'. :: ::% <'1 G� . <br /> Thc Premises are to bc used as a......_..................._._..__........................ ......�......... <br /> '1'iic owncr of the premises is.__._.............._................................................_._........... <br /> Thcagent is..........................................___.. ..........._........_..................................._...... <br /> Ti�is application, althouth sigrycd, shall not�e binding on the City, until <br /> accepted b,v the Super'nt9�de\ of t}� \V:tt�r epattment.�_ <br /> / , �,. .� / - • .I �-��� <br /> SiFne�..`�............:...1..../.��..........1£.�4.!...y...��...............Applicant <br /> ,\ccepled..........................................^I�....... By................�.............................................. <br /> Superintendent. <br />