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.� <br />�: � -�-- <br />W. D. Fo�m 4 . /C� �• �� <br />CITY OF EVERETT-WATFR DEPARTMENT <br />APPLICAT�ON F�R WATIER <br />All blanks must he filled in or crossed out <br />Everett� ................./��� �.....:...�........................................19�'. (� <br />TO THE SUPERINPENDPNT OF THE WATER DEPARTMENT: <br />CITY OF EVER�TT: <br />I hereby apply fm� lhe use of �vater in acaordan�•e with the rules and regu- <br />lations uf the Water Department, for purposes ar.d fixtures staled Uelow. <br />During tlm time that any o[ lhe watcr mams may bc taken up by rcason <br />oC any improvements aulhorized by thc Cily of Everett, in or o[ any strcet or <br />allcy in which lhcy� mny have bcen laid, thc City will not 6e req��ired to furnish <br />�vater during the progress of such improvements to any conswuer whose sup- <br />ply may thus be cut off, or bc �a�le tor any damages t9r its failure so to do. <br />/ <br />Application No..... . Y 1 <br />....�..J .. . .................... ; . ' <br />." � ' !�- �-c��:��-�c�,�t- <br />. dd7 L�..�"' _ <br />Slock.......� ........................... Lot.........�...........................� " � ,{�........ <br />/ /� l <br />No ........................3 �?.. j�.Q....i�:C�cG.lC�...l.�.,(:.[.�_r�._.....: ...........Slrecl <br />............ ....................................................................... <br />The work .o be execuled by ..................... <br />S:a.c �im of tap. <br />.._... ......Tap lu bc inscrted in the main <br />' Nater doset <br />��......... <br />...ry.......II�th <br />................ U ri nal <br />..__ _......YJain Caucet inside <br />.....__.......Sidc �oalk washcr <br />................Huse Uib ou.sidn <br />.._._.........Hos^ bib for building purposes <br />_..._._._._Hosc bib inside <br />....... _....... ....Pl�mbcr <br />�; <br />JC`�l���GL[f(�t%% �[n'.;c� <br />�' <br />> � ��C <br />'�I�-C-c: �L<' <br />s�'�?- <br />.............._Bib tor s��b;c conlaining...................stall.................. J <br />-, <br />C /%,'-G �i✓.t �ia� <br />... Numbcr of persons in family ,C-GG�sU(/ / <br />_�c........Numbcr ot rooms in building �� r�t �7ttt1L����c�7 <br />Thc premises arc to Uc uscd as a............_.._ ........................._..........................._.... <br />Thc owncr of tlic Premises is.........._ ................_.............._.........._.............. __....__.. <br />'PSc agent is..........._....._..........._._ ........................._......_................._............................ <br />This application, althouFh siFned, shall not be binding upon lhe City, until <br />nccepled by the � per�injtendent of lhe �Yatej Department. <br />Sf�ned.Lf/.<<.1�.�-a..t.......// " ..`..�r�.C..�- ...............................Applicant <br />AcceptccL......_.._ . .... . .._._....1^....... L'y- �---_.__ . . ...__.. .. ._........... <br />Superintendent. <br />