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/:J/Y?r) F <br />W. D. Form { 1500 3-1-17 C. P. <br />CITY OF EVERETT==Water Department <br />Application for Water <br />All blanks must be filled in or croscout <br />Everett-_—___----- - -� - - - ----__19-- <br />TO THE SUPERINTENDENT OP TIIE WA ER DEPARTMENT, <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance With the rules and regula. <br />tions of The Water Departm=nt, for purposes and fixtures slated below. <br />During the time that any of the water mains may be taken up by reason of <br />any improvements authorized by the City of Everett, in or of any street or alley in <br />which they may have been laid, the Citv will not be required to furnish water during <br />the progress of such improvementx to any consumer whose supply may thus be cut <br />off, or be liable for any damage�(s for its faiktre so to do. <br />Application No.___77_.!/ ._---- vt_ <br />Block ...r _- - ..r-I a _ /�_'_ -- --._ Add ------ -----------' <br />No.-----K-.. ..................... ----..Street <br />-- -- <br />------------- Plumber <br />-- u-moo <br />The work to be ;J,eculen hv. _--- ----------- <br />State s1ogf top. cAt p O O <br />._]�/'y-Tap to be inserter a the main. / 0 <br />------- (.-Water closet <br />__.-__. __Bnth <br />vnnar <br />------ !__Plain faucet inside <br />---------- Side-waHrW7Tsher• '^I <br />-]_._Hose bib outside \ / <br />parPoSCs <br />Bii ksrininK- ---------- <br />---------- Number of persons in family <br />----- S .Number of rooms in building <br />lie premises are to be used as a __ _ _________ _ ____ _____ ___ ___ ------ <br />The owner of the premises is __'_____ _ _ _ ____ _ __ _te-___-_ <br />Theagent is .____-_.._.-----------------------------____-_..-___.-______ <br />This application, although signed, shall not be binding upon the City, until ac• <br />cepted by The Superintendent ofjjL1 pa vent. <br />Signed_. ... _ � —. rT'• __...._.APplicant� <br />r Accepted.- it -._.____-----D <br />xY�V-�� Su erintendant <br />4 <br />