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1y� ` <br />W. D. Fo�m 4 <br />CITY OF EVEREiT-WATER DEPARTMEPJT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />7 — <br />Evcrett.......................�..'..... �................... ............_........19 �_�� <br />TO THE SUPERIIITENDENT OF TI�IE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />7: hereby apply tor the use of wnter in accordance wilh lhe rules and regu- <br />la!iois of the R'iter Department, for purposes and fixtures staled below. <br />DurinF tt.e .:me th:�t any ot the watcr mains may be tnken up by reason <br />o[ any impro��emenls autho��ized Uy the Cily of Everett, in or of any strccl or <br />allcy in whict thcy may h.;: �_ bcen ]aid, lhe City will not be required to turnish <br />watcr during �he progress of such improvements lo any wnsumer whose sup- <br />ply may thus be cut o[f, or bc liable for any damages for its failure so to do. <br />Application No...... ��_(��:_�..�.�.Y.... _ / ..� / �t <br />; �, /, C�. ,�- i <br />Block...............�r.- ....... .........._. /Lb���..`.......��....��i................. Add............_._.................__.... <br />No ................_.......... .��..f /.....`............:......-l._7 `..�f-z.:=.-.[:�j-..........Street <br />� <br />The work to be eteculed bY ............................_......_..................._............Ylumber <br />Statc sizc o[ tap. <br />................Tap to be inserted in the main. %' ' <br />��[.t Z� � � c r: c/ <br />................Watcr doset % % <br />......�........Bath / . �..��- <br />/ /._ f�-✓_. _ <br />................Urinal � <br />................Plain [sucet insidc <br />..._...........Sidc w:ilk washcr , � <br />�. <br />................I{ose bib oulsidc -, . � ; .: 5 C <br />1; • <br />................Hosc bib tor building purposes `' .� 4� � 1 /.�i_ , :«' � �r <br />er.i' / � <br />.........._....Hose bib insidc � !.(� ' / � <br />� �'r.,,:.., y <br />................Bib tor slable containing....................stall.......::.._'.�.... <br />._.......,.....Number ot persons in family <br />..._5..._...NumUcr o[ rooms in Uuilding <br />The premises are to 6c uscd as a ..............................................._........................ ..... <br />The owner oE the Prem�ses is ................._.....................................................___. ...... <br />Theagenl is._ .............._.........._..._.......___..............................._......................._........_. <br />This application, althoufi�� signed, sha]] not be binding upon the City, until <br />accepled by the Superintendenl of-Ihe \�ale�r /Depart/�}enl. �+— <br />:iL�. 1 i �f,.l�ti6Y�C"".,.''�r...�icant <br />Signed......�...1��...�� .:...............:........ (::..........._ ......... <br />Aceepted..___.._........_ .....................1�....... By............__... _.........................._.................. <br />SuPerintendent. <br />