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_ � .. c_....-3,.Ci.,,���_y_ i..� ii r.� . <br /> l�.D.Form�—IL00—E.P.Co.-6".6-R/ ' ' " ' <br /> City of �verettr--Water Department <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or crussed out <br /> Everett.......................�� .s.,:�.............� .....102.5.... <br /> TO THE SUPERINTENDENT OF TI CER DEPARTDtENT: <br /> CITY OF VERETT; <br /> I hereby npply for the use of�eater in nccordance with the rules nnd regu- <br /> lations of the Water Department, for purpnces and fistures stnted below. <br /> Puring the time that any of the water mains mny be tnken up by rcason <br /> of xny improvements nuthorized by the City of Everett, in or of any atreet or <br /> elley in which they may have been leid, the City will mt bc required to furnish <br /> wnter during the progress of such improvements to any consumm• whose suPP�Y <br /> muy thus be cut off, or bGe lG:nble f(a�r nny damagea 2for its fnilure su to do. <br /> APPlicntion No:.........0�..0...�...U...... � 'l� � ` . <br /> .... <br /> Block........................................ I.ot.......................... .... ..... Add.................'..�..::. � <br /> /j"� ._.._,�........ <br /> No..........�..3..�..y............G..�.' ..'<-�-O3treet • <br /> .._........_...._._............................................................................. <br /> � ............._..... ..... . .......... <br /> Tl�e �vork to be executed by........_............ -..4c-.�..p�umber <br /> G G' <br /> State aize of tap. �-�� O <br /> ....�2r.Tap to be inserted in the m �il - � , <br /> .......,,f.....Nater doset Y � V <br /> ......../......Bath �U�`� ' � ���a ' <br /> .........�...Urinal i.IN OF EVEREiT M��TER Gi�'n <br /> .- .. ___... <br /> .........."�..Plain fnucet inside ,v ..............��::.._.... <br /> .......,./.....Side walk tvasher <br /> .......--......Hose bib outside <br /> ..-....—:.._Hose bib for building pm•posca <br /> .....::........Hose bib inside <br /> ........—....Bib for xtable containing....................stnll.................... <br /> ......_—....Number of peraons in fanily <br /> .....,'�t`�..Number of rooms in building �(�) "� � <br /> The premiaes are to be used as a..........(t..(�]c(c(�(i..l(..�._� .��� <br /> i <br /> � The owncr of the pretnises is.................................... .. . <br /> . . ............................................. <br /> Thengent is.................................................. <br /> .................................................................... <br /> . This applicntian, although signed, ahall not be binding upon fhr. City, until <br /> , ;nted by the Superinten ent of lhe �i'ster Depnrtment. <br /> � Signed............ .................................................................. .............Applicant � <br /> - �� . .. , ...192...... B <br /> ......................... y........... <br /> . . ...... .... <br /> ......... <br /> ' '�� `/-2 �� y� uperintendent <br /> ... � . � ...�'d '. <br /> . <br /> w <br /> . <br />