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W. D. Form , 1500 3-1-17 C. P. <br />CITY OF EYERETT—Water Department <br />Application for Water <br />.All blanks must be filled in or crossed opt <br />7//� ---- --_let? Y,_ <br />TO THE SUPERINTENDENT OF THE WATER DEPARTT1ENT, <br />CITY OF EVERETT: <br />1 hereby apply for the use of water in accordance with the rules and regula. <br />tine, of 'rhe Water Department, for purposes and fixtures stated below. <br />During the time that any of the water mains may he taken up by reason of <br />any improvements authorized by the City of Everett, in or of any street nr alley in <br />which they may have been laid, the City will not be required to furnish water during <br />the progress of such improvements to any consumer whose supply may thus be cut <br />off, or be liable for any damagesforits failure so to do. <br />Application -------- <br />Block ._.__"J_-_?'_ _"—pj',ot----- �_______------- Adt <br />No ------ --- O_Q._:.!A'�.! ........... Street <br />The work to be executed b•------- �✓f_iLtt*..rsti----------------- Plumber <br />Stale s' a of tap. <br />l0 6e inserted in the main. <br />00 <br />__Water close <br />.t <br />.__._ ..Bath <br />_ .Urinal t <br />i ___... Plain faucet inside f <br />1 _- ... Side walk washer <br />------ Hose bib outside <br />---- - ---- Hose bib for building purposes <br />. _ _ _ ----- Hose bib inside <br />__Bib for stable containing.______ ----- stall ....... <br />l� '___Number of persons in family <br />.__T ___Number of roans in building <br />iThe premises are to be used as a __. . t..LK_......... _....... _------ ______ <br />The owner of the premises is _____ _.__ .. sf.4Tni_____________________ <br />Theagent is .___..____.._o-..__. ---------- ____________ <br />vpplication, although signed, shall not be binding upon the City, until ac. <br />,it no 't^ Superintendent of the ater Department. <br />+� <br />Signed /.ti___-- -- ._ --CsT^ ��A711icanr <br />/!/ modem -' <br />