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� �. . <br />W. L. Foim 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATI�N FOR WATER <br />All blanks must Uc filled in or crossed out <br />_ _ ._ <br />Evcrolt,........._.......,��`..:�.-.<.-,,..__-.'..._-' l�Jl.--" <br />_.._..._... _.... <br />1'O THE SUPERiNTENDENT OF 1�HE WATER DEPARI'nSENT: <br />CITY OF EVERETT: <br />I hereby apply for lhc use of water ir. accordancc with Um rules and regu- <br />]alions u`. thc R'atcr Department, fot purposes and fixWres stated Uclow. <br />DurinF lhc timc that any of thc watcr mains may bc taken up Up rcason <br />n( an9 imProcemen:s authorized by thc Cily of Evcrett, in or of any strecl or <br />alley in �chich they may have been laid, lhe City will not 6e required to furnish <br />���ater during the progress of such improvements to any consumer ���hose sup• <br />ply may thus be cut o[f, or be liable for any damages for its failure so to do. <br />� G'J �F <br />Application No...._ :.................................. <br />�J .J� <br />Bock......... ..._.... ........ LoL. -:".. ____..._.._.._... Add _.___ ... . ..... ..__. <br />No......_�'�.'... .�,.�.C�<��.��2t4�......._.eC3.?.s.s: <�......_........._,.......Strccl <br />_ _ . .......... ....................... _....._ _....... _.........._......_................................................................_._. <br />Thc work to Ue executed by_ .._ ............... <br />Sta't�c sizc of tap. <br />.. ly T:�p to bc inscrled in lhe main. <br />.. .,._�i'alcr doset <br />. �.....`.:.Bnth <br />.__........._Urinal <br />. .............?]ain faucct insidc <br />__.__.__..Sidc walk a�asF,ar <br />............._.._ __...Plumbcr <br />/ ` �'`„cLL � <br />�?, - � <br />�C.��;' " <br />._ ._......_.Hosc biU outs�dc :4- n. ��.• -. <br />_.........Hosc biU for Uuilding pm�poses >>. �.."_ rr ''� � <br />�J <br />° � ��- <br />. ._..._......Ilosc bib inside ,- . . <br />____........IIib fnr staUle conlaining ....................stall �., ....._. ... <br />. ____._...Number of persons in famity <br />. ... �i. .NumUcr o[ rooms in building <br />The P�'emises are to Ue used as a......____.___.._..... . .. ..._ .. __. <br />7'he o•amer of the premises is....._. __....._. ......._. .__..._ __. . ... . _ __. .. . <br />T;w aKent is_... .._.........._.. ____. _.__......... ._.._.._. ._.__... <br />1'his application, althnu�h si�ned, =ha11 not be binding upon the City, until <br />ac��rptcd by� the f uperi�n�/ic t o[ ic YWatc,C Uepartmenl. <br />SiFned�. V..f o-�.`.�'.�/.1_....��.� -�:2:r�.._ . .. ...........Applicanl <br />.�. <br />Acrr��;ed _. _.... . . ... _...1�... .. I3y ...__._ _. .._.. <br />Suprrintcndcnt.-. <br />