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W. 0. Foim 4 <br />CITY OF EVEREIT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />G �— <br />Everelt� .............. .:t_.C. �.: ....._c�-�.!...._...____._.....19......... <br />�.... <br />TO TIiE SUPL:RINTENDENT OF THE W��ER DEPARTnSENT: <br />CITY OF EV�RETT: <br />I hcreby apply for the usc of water in accordancc with the rules and regu- <br />lations- ot the �Vatcr Department, far purposes and tistures stated below. <br />During thc time that any of the watcr mams may bc taken up by reason <br />o[ any improvements authorized by thc City ot Everelt, in or ot any street or <br />alley in wh�ch lhcy may have bcen laid, the City will not be requ:red to tutnish <br />waler during the progress o[ such improverients to any consumer whose sup- <br />ply may thus bc cut o[f, or be liable for any damages for its :ailure so to do. <br />�!l �����5� J-� <br />Applical� No ........ ........ �........ • .c�-%. . . ��" ^ "� <br />�1/� �"��,[ <br />Block........................................Ip t../........�......y.,......._...�, Add...............r................../_...... <br />No.........s.....:...:�r.'..........i.7...t:.G��� :...rl=CJ� � � n -,.5..:` .............Strect <br />� 3 n ��....... <br />Tne tvork to Ue esecuted by............_........ <br />✓ft�aLt,c size o[ tap. <br />'7 Tap to 6e inserted in the main. <br />Walcr doset <br />c..��. ',........... B a t h <br />................Urinal <br />_.._._ .........................._ Plumber <br />� �� �v <br />� OG ������ <br />� �) <br />_� ✓ <br />% + r� <br />G'- u r . <br />•-� <br />................Plain faucet inside /Lt'-J�J-^f� � <br />.....Sidc walk washcr � ' � <br />.............._Iiosc bib outsidc 1���' ^ �- L'�-"' <br />........... ' <br />................Hosc bib for building purposes ;;� � V . ,/ <br />� 1 "' <br />................I�Iose bib inside - ' � ��� <br />...............Bib for stnble conlnining......_...._.....slall............_�...1; ,� J ,�4 <br />......... Numl�er o[ persons in tamily . <br />� .. NumUer of rooms in building �'"�'��'� "'- � °� /�. . � '�.It <br />Th�remises are lo be used as a ................._ -�" 4 <br />._ .............................: _. :,.._ ;_� .. :). .... <br />The ^�vner ot tlic Premises is........._........___..........._ ................_ _.._. ..........__._..... <br />TScagc t is ...................._.................__......_.........._......................._............._............... <br />This application, nithou�:h signed, shall not bc binding upon thc Cily, until <br />acccpted by the Superinter.!dent of the R'ater Departmenl. <br />Siqncd.......L.!�..��.—. ��... ���.._......_ _..._.__..._............Applicant <br />Accepteil_..._.. _....._._. _..1�.._... f3y..�._._ .. ..... . .... .. .. ... ........ <br />SuPcrintcndent. <br />