Laserfiche WebLink
/,���, <br />W. 0. Po�m 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everelt ................._......._......' ��'��_!�1..........._.......19 G'.l <br />�.... <br />TO TFiE SUPERINT�NDENT OF THE \VA ER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply tor the use of water in accordance with the rules and regu- <br />lations of the Nater Deparknent, for purposes and fixt�res stated below. <br />During thc time that any of the water mains may be taken up Uy r�tason <br />ot any improvcrcents aulhorir.ed by t'nc City ot Everett, in or of any slreet or <br />�lley in �ahich they may have been laid, the Cily will not be required to furnish <br />�sater during lhe Progress ot such improvements to any consumer whose sup- <br />?ly may thus be cut off, or be liable for any damages for its failure so to do. <br />Ap�lication No...l...���y " .............. .. <br />91cck........_.�'............_......... Lot...ti.��:...�P ...................... Add�.v......c..�� �. _/_G <br />�' ' i. <br />,/ 0 <br />No............r.�//�.:-. �4:�,Fo�e-�C?t.. �.:...�x�c_ ...........Strecl <br />.. ..... . .................: <br />The �vork lo Uc executed by... <br />Statc sizc of tap. <br />_`�<�....Tap to be inserted in the main <br />/ J,�..........Natcr closet <br />� �:.�:.........IIaUi <br />................Urina 1 <br />................Plain faucei insidc <br />................Side walk washer <br />................Iiosc bib outsidc <br />................Hose Uib for building purposes <br />......._..Plumbcr <br />na <br />(. � '�l' <br />�, '., �� <br />"1' `'� �'t� �,� <br />��F or �,�f /` i <br />�%�. r_�.. .� �- . <br />6' <br />,�;�j.:<!� ''L� <br />� l, <br />' � R,ci <br />� e' <br />E � <br />.._............Hose bib insidc ` <br />................Bib for stablc containing..........._...._stall__..._...__.... <br />..............Numbm� o[ persons in familp <br />.. ..�....Numb: r of rooms in buildins <br />The premises a�e lo bc used as n. ___...._. ._..._. ..... .._ _.. _.._... <br />Thc owncr ot the Premises is....__...__............_....__ .............._._._....__.... <br />The agcnt is ..................................___.............._....._.......................__........ <br />. .... _...... _..... <br />This apptication, althou„^h signed, shall not bc binding upun the City, until <br />accepted by the Superinlendent ot th/e �\'ater Dep�rGnent. <br />Signed{:...�� f .�cr...._G1(..: !{""?..... �r....�.�...f:P�. J........_.......Applicant <br />00 <br />Accepted...__ ... ............._.__.__.._.]P....... Bv........._..........__......_............._.__....._....... <br />Si�perintendent. <br />