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/ �' �' '� % <br />\4. D. Form n <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />Atl blanks must be filled in or crossed out <br />Evemlt .................................._�-...c....�"...5 .v:.� <br />........_...._....19_.: ,� <br />TO THE SUPERINIENDENT OF T}iE \VATF.R DEPARTilSENT: <br />CITY OF EVERE'!'T: <br />I heteby apply lor the use ot water in accordance with the rules and regu- <br />lations of the �Vatcr Deparlmenl, for purposes and fixtures stated bclow. <br />During the timc lhat any ot the watcr mnins may Uc i�ken up Uy mason <br />ot any improvements authorized by thc City ot Evcrett, in or of any strect or <br />allcy in �vhich they mal' ����'e bcen laid, the City �vill not bc required to Surnish <br />tcater during the pro�ress of such improvements to any mnsumer whose sup- <br />ply may thus bc cut o[f, or be liablc tor any damag tor its failur/e so to do. <br />� 7 �Cc ,�,�-�': �C���JG � .,: <br />Applicalion No......... . 7� <br />�! .,y.......�..... Zb�rc:,�� ,ciC.� <br />II(ock ....................................... Lot..._.�.�.................. Add..._,1..',�� J�.c-.:e.� <br />N� ................_....� /.3. f,�". _ ��.....�� , /�(��..W f..s���/' <br />�.. . <br />_ ...................................................................................................................__................... <br />The work to be executod by--. _............_ ............._.................._...__ ......._B1umUcr <br />St:do sizc ot tap. /' <br />��,/ C,!'4��' �(f!'�C <br />G <br />..........Tap lo be inserted in the main. <br />..._..._\Vatcr doset <br />._��........Bath <br />. _ _...........Urinal <br />...._..........Plain faucet inside <br />Sidc walk washer <br />..............Hose bib outsidc <br />. _...._......Hose bib for building purposes <br />................Hose bib inside <br />, ,- � , <br />/J . j � (' C�. c �� <br />C �/ � _�Uti%�� <br />. `' C� i � ;,J' <br />....._.........Bib tor stable containing._........._...._stall......._.....__.. <br />.. Nmnbcr of persons in familp <br />_ .�'t........NumUcr at rooms in building <br />Thc premises arc to bc used as a.......... .._._. . ___... ....._ _._... <br />The awncr of the Premises is......__......_... ......._........._.._...._. ......___. _._.. __. <br />Theagcrt is ............................__.._.................__....................__...__._..........__............ <br />Tliis application, althou�h si ned, =hal] not Ue inding up n the City, until <br />accepted Uy the Su rinte den - f t /\Patp� D�fS�,tment. j <br />S�H d......�..5..�...z...�L..l _C'�1.�<.I_ _.�•`...�CAPPlicant <br />i <br />r\cc��p:cu ..__ . . _ _,:,.....10...... I3p -_ _.__� <br />...._.... _ . ................ <br />" Superintendent. <br />