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OF EVERETT-W�,TER DEPARTMENT <br />APPLICATION FOR WATER <br />All Ulanks must be filled in or crossed out <br />. i <br />Evcrett ..........................�s:..-.c.,....:..,J.....................19 C'.� <br />TO THE SUPERINTENDEA'T OF TH$ 1CA.TER DEPARTT4ENT: <br />CITY OF EVERETT: <br />I hereUy apply for the use of water in accordance with the rules and regu- <br />]ations o! Qic \Vater Department, for purposes and fixtures stated bclow. <br />During the time that any o[ the tvatcr mains moy bc taken up Uy rcason <br />ot any improvements authorized by thc City of Evcrelt, in or of any strect or <br />al!cy in which lhcy may have bcen laid, thc City will not be required to furnish <br />water during the progress o[ such improvemenis lo any consumer whose sup- <br />ply may thus Uc cut oft, or bc liable for any damages for ils failure so to do. <br />APPlication No.��.���,f :.............. <br />. ._: <br />Block ......................__.....�...�... Lot...._.../_%�..................... Add(�.c.:�,...:.: �..c.,.>,._.. <br />No.......n�_��.r.j...��:.Ga �....../...��z�.;Fzc 2..L�'.�-........_..SIrCCt <br />Thc work to be executed by._ ............._..................._..___........__.........Plumbcr <br />St� e ize of tap. <br />�Tap to be inserled in the maia ��� � f <br />... � z�t, � <br />................�Vatcr closet � � <br />...�........Hath { H�*� 1 �,,-,.� <br />.._............Urina] � �,,o� �„ �, <br />: I <br />................Plain faucet insidc � "� ' i�l .�� <br />.-_..___....Sidc walk washcr . �, � � <br />.. .............Hosc bib oulsidc � � %� �y� '� <br />................I4ose bib for building purposes ��U� �� L. <br />L <br />..... ..........Hose bib inside <br />._..._._.....BiU for stanle containing ...................stall.................... � <br />__._._/......Numbcr of persons in family <br />....__(.-._.Numbcr of rooms in building <br />Thc premisrs arc to bc uscd as a._._ ................_.__.._.........._...__........., ......._........ <br />The owncr of the Premises is ..........................._......................._..__.__.........._.__.._. <br />TSeagent is......_.........._._ .............__..._........._........................_......_..........._..._......_. <br />This applic;�tion, allhouFh signed, shall not b Knding upon the City, until <br />accepted by thc Superinten nti Qt the \5'a�fr ��tment. , <br />�� �% <br />SiSnedX........ �.� _�......L..��.....�'...«i! ')�L�.�..Applicant <br />/ <br />�,.�.,..i:ci.... . __ .. ...�..I!!..... I3t'.. __..�_. _...__. .__. <br />Fup��rint��n�k�r.t. <br />