Laserfiche WebLink
_� � r % <br />� �,, , " <br />i �� �, � `��` <br />� .�v� ��1�. <br />�< «� � ,z <br />�r r�y,��+:,.wi�h <br />W. �. Fo�m 4 <br />CITY OF EVEREI'T-WATER <br />t=�---�`- <br />� <br />DEPARTMENT <br />` APPLICATION FOR WATE& <br />All blanks must be filled in or crossed out <br />Everett ................. ... .._..:. r. " . .....19_��-y. <br />,,�-... ,,....L:......._........._. <br />TO THE SUi'ERINTENDENCIT�Y OF E ERETI;DEPARTMENT: <br />I hereUy aPPI}• for the use ot water in acmrdance with lhe rules and regu- <br />lations of the Water Department, for purposes and fixWres stated below. <br />During lhe lime that any of lhc water mains may be taken up by reason <br />of any improvements authorized by the City of Everelt, in or of any slrccl.or <br />alley in which they may havc been laid, the City will r�t bc rea_�ved to [urtush <br />waler duriug lhe progress of such impcovements to any consumer whose sup- <br />ply may llius bc cut oft, or bc liablc for any dama6es far ils f�ilure so to do. <br />�..�.�7� /� .� f'�— <br />Application Na..,c..r.�....:_ ..- ........ ............ <br />� �--1--�,.:._..........Add....:�:.,..,.....�..........._.... <br />Block.......... :::._�.................... I.ot.......:............. .. <br />�' �`/ ) Jr i �c..l.^..:�_�.- ...................................:...........etrect <br />No.........:.:..... � .... .................. . <br />.................. _......._........................ .............................................-------.. <br />. ...PlcmUer <br />The work to Ue executed by... _............_ ........................._........_........... <br />Statc sizc of tap. <br /><j�/.....Tap to be inscrted in lhc main. <br />.. Water clrcet �� � ' <br />; ��'Ii,..� G�� 1 <br />..��-�.....Ba[h ip ,,.T.�:� i� . <br />L�✓�t <br />.. .. .....Uri�al 7 i! � <br />................Plnin faucct inside ,... . � <br />, .., f�. ,�. <br />, .�_ �� ���� � <br />................Sidc wal1: •.vasl�cr IL. �.: <br />................Hosc bib ontsidc � � �': '�•� � � ' <br />,,.........._..Flose bib for building Purposes ',':,;; � ,; <br />,,.........._..Hose bib inside <br />...... <br />_........Bib tor stable conlaining.........._.......stall..._..__... ... <br />......_........Numbcr of persons in fatnily <br />,. ,r.......Nmnbcr of rooms iu building <br />Thc Premises are lo Uc used as a._............__ .....____. ..._...__ ._ .._.._ __.._. _... <br />Thc owner of lhe Premises is......._.........._ ... ........__.._...___ ____..... <br />_ ...... ..... . ..... <br />Thc aSent is._ ...................._.........__..._.........__..........._......._.... <br />.......... ........ .. _ _ _.. _. _. <br />Signed..,,'t,'�"�h ��g�ed, shall not Uc bindinC unon ti�c Cit}•, until <br />� p intSn enl o[ the Watcr Deparlmentr � /� <br />accepte 1 bY��tl c�Su��•eY.....��!N.'.. , /�'l�✓...�.��.�<!^...Applicanl <br />// <br />! 1!.-. <br />_. _.. .....I� ....... IIY. .._._.. _.. _......_..... ....._....._ ... .................. <br />AccePled........_._..._......._._. SuDerinlendent. <br />