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ti,�',' I <br />taJc?Y:`' ��,;'� � . . � <br />�-�__ -, f <br />�'7 ..�; �. L <br />�,a � :, � �I <br />�j Cf <br />:i}`�""" 1 ; <br />'Tjk'�.s ' � <br />�F�tS }I'- ' . <br />y@:.�.. .. . �� <br />�'� <br />% %�'— <br />W. D. Fo�m 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />�PPL�ICATION FOR WATER <br />All blanks must bc tilled in or crossed out <br />Evcrclt� ..............................��:te. :- 19_C.<i <br />t....,. � .......................... <br />TO T'IE SUPERINTENDENT OF THE NATER DEPARTMENT• <br />CI7'Y OF EVERETT: <br />I hereUy applp for the use of �vater in accordance with the rules and regu- <br />lations ot the Watcr Department, for pm�poscs and fixlures stated bclow. <br />During thc time that any o[ thc watc: mains may be taken up Uy rcoson <br />of any improvements authorized Uy the City ot Evemlt, in or of any strcet or <br />alley in �vhich they may have been laid, the City will not ba required to turnish <br />�valcr during lhe progress of such improvements to any consumer whose sup- <br />ply may thus be cut oft, or be linUle tor an}• damages for ils failure so to do. <br />Applicalion No..��1. �r�. ....... / <br />�1.........._....... Add./...li7-C���:L�-�.�._�/ <br />Block.............._........................ Lot.__............_.�7 <br />No.._........_/..f'....4.,:3.-.....%%.... �tLa!!:/Rx.r .............................Strcet <br />Thc work to bc esecuted by ...................... <br />Slate size of tap. <br />...�1�....Tap to 6e insertrd 'n the main. <br />Pluml�er <br />.... .......Naler closrt �;L��-�'�� <br />...G.3..._..Bath // La�" � ,o <br />................Urinal /"� / (• 5 !'l <br />. .............Ylam faucet inside � � ns?� � � � <br />............ Sidc walk washcr �1 � ~�Y' , -�`r y^ /� �,/ <br />� . <br />i*1 <br />Hose bib outsidc 7) �. <br />_ ,�9 <br />................Hosc bib for Uuilding P��'Pos�i '. ` � �� ' j � <br />...............IIosc bib insidc '.. . . <br />............. Rib for stable contain:ng ....... �.:stall.._ .......... <br />........._....1Vumbcr ot persons in iamily � <br />..._�......N-.�mbcr of rooms in Uu�lding <br />Thc premises are lo uc used as a .. ....................._...................................................... <br />Thc owncr of ihc Premiscs is_..._..._..._... ._......_ ................._.............._...__............. <br />TSr. aSent is ..................................._._..............___....__........_...._....._....................._.... <br />Tl�is application, althnuFh signed, shall mt bc bindinF cpon lhc City, until <br />accepted by thr Superinten en/ o[ the Nater DeparUnent. <br />SiFned..� -`���(:�'-��''.c'�..: ....... _ .............Applicant <br />Aceepted............................................1�....... By.................................................................... <br />Superintendent. <br />