Laserfiche WebLink
/;i�/ <br /> W.D.Fo�m 4 <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crossed out <br /> i, F- ' � <br /> Everett..........................._,�.r..�.:_.:._...,................._..........19�::� <br /> TO THE SUPERINTENDENT OF THE WATER DEPART`4ENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules and regu- <br /> lations o: the ti9ater Department, for purposes and fixWres stated Uelow. <br /> During the time that any ot the watcr mains may be taken up by reason <br /> ot any improvements a�rthorized by the City of Everett, in or of any street or <br /> allcy in which t::�y may have been laid,the City will not be rcquired to furnish <br /> waler du:�ing the progress of such improvements to any consumer cuhose sup- <br /> ply may thus Ue cut off, or be liable tor any damages for its failure so to do. <br /> Application Nol r./_.�_�.—.............. <br /> � � <br /> , . <br /> Blor.k................_......................Lot.............._�................... Add.._!_.'.:t::'I:lf.:,:�.:... <br /> _ /j <br /> No.........:.::�.�. �::...../_�s.:._�t.-�.._-�-:............................................_........Street <br /> ...................................................................................................................................................... <br /> The work to be executed bY.......................................................................Plumber <br /> State size of tap. <br /> ..:�.....Tap to be inserted i� the main. <br /> ... . ..._Water closet ppp - J J � <br /> � � � p '� u <br /> .....1.......Bath p � � �; j � <br /> ..._.._....._Urinal /J <br /> ul'�VV �u� ,/ � <br /> .._.__..._..Plain taucet insidc � <br /> .............._Sidc walk washer ' -�7 <br /> , � c" <br /> .............._Hose bib outside Ciiy Of r` "`.I /% <br /> ................Aose bib:or building purposes �,�a��n D�-�'��• <br /> ::� ; <br /> ................Hose bib inside <br /> .._............Bib tur s�aule containing...................stall.................... <br /> ................NumF.er of persons in family <br /> ......:�j.....Number of rooms in building <br /> The Premises are to be used as a..............................................._.............................. <br /> Theowner of the Premises is....................................................................................... <br /> Theagmt is............................__.__........._..................._.............._............................... <br /> This application, although si�ned, shall�ot be bindin�.upotffhe City, until <br /> accepted by the Superinten,� lh"e�5ter epartrrcerL. <br /> Signed..\'......_../.......x..�/lG/�.<��................Applicant <br /> Accepteu......._.._.__......_..................]°.._... By ./..�...I._......_................................................ <br /> Superin!endent. <br />