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11-11- X1 f r r 5-1a_LA� 1- 13 - ��' 1 <br />W. D. Form 4--1600—E.P.C.: 626-RI <br />City of Everett�"Water Departm^nt <br />APPLICATION FOR NVATER <br />Ail blanks must be filled in or crossed era <br />d ...........192....- <br />TF <br />TO THE SUPERINTENDENT O OF EV I ET :DEPA TGIF.\T• <br />I hereby 1.pPlY for the rse of water in,cs accordance <br />xtnres stated belothe rules w. <br />of the Water Department, for pu1P reason <br />During the time that any of the water nmins may be taken up by <br />aof lley in which they may have be211 laid, the City y the Cit" Of will not ibex e4uiredr of ytotfurnish <br />,lay thusribe the cut off, Progress <br />liable for anysuch vdamages ofor itsofn'ilurersolto do.ose upply <br />ppplicnti n No..... Y._... ;.'....I.......�..�l � 8 <br />Vp Lat. ............. %'..................... Add......:...... . ....................... <br />No......._�e...-..�..µ.,.+(.. ............................................Street <br />.......................... <br />--�"" " Plumber <br />..................o.. <br />The work to be executed Y.......................... (f <br />SI d <br />tpto„size of tap. <br />-./.2:........Tap to be inserted in the mt i::. I �� <br />.....R'nter closet -t <br />....l........... Bath <br />................Urinal <br />................Plain faucet inside <br />................ <br />..' . ... Bose <br />walk washer <br />,....ose bib outside <br />................Hose bib for building purposes <br />................Hose bib inside <br />................Bib for stable containing <br />.................... stall .................... <br />Number of persons in family ' <br />,r...... <br />of rooms in building <br />�.lA............... <br />The premises are to be used as a........ .����� - <br />1 d C4....................... <br />The owner of t11c premises s............ ....................... ... <br />................................ <br />Theagent is...................................................................................... <br />This application, although signed, mall not be fleeing upon the Cit Yuntil <br />, <br />accepted by the Superintends oath <br />Atyr t. <br />G'Ul..... • .......................Applicant <br />Signed.......... ........ ................. <br />s� .....'.92. ... BY-... .. <br />....... <br />Accepted...Superintendent <br />