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Il <br /> 1 <br /> 1 <br />� <br /> . . _ . . C/,/l�-i �.— <br /> . .�;a ��P � .. .. _ � / <br /> i�+r . t.;1, � - W.D. Po�m 4 <br /> o � '§ y'�°: '� '"" � `� - GTY rJF EVERETT_-WATER DEPARI MENT <br /> APP�.ICATION FOR WATER <br /> All blat.l-:. mttst bc filled in or r.rossed oct <br /> IEverett�............... ......._......._.�.?-:�?:4'_.._':_..............19..(�....� <br /> � TO THE SUPERINTENDENCIT�Y OF EV RETTDEPARTMENT: <br /> I hereby apply fm• the use of water in accordance wilh the rules and regu- <br /> lations oE the Nater Department, for purposes and fixtures stated bclow. <br /> During thc timc that any o[ thc walcr mams may Uc taken up bY reason <br /> of :my improvements authorized Uy the Cily of Evcrett, m or of any strcet or <br /> allc}-m which they m�y l��vc bcen laid, the Cily will not Ur, required to furnish <br /> P�y�mYyut}i stbc curt o[fsar bc liablc[or�any damages for�ilsUfa'lurcls� to do. <br /> ppplication No..../...�/`!�'........ <br /> . /S—/(r __........ <br /> Block........................................Loi........................................ Add............................... <br /> No........._='/.�.1..... . ..�;r.� <br /> . .................... <br /> ......................... <br /> ...........Strccl <br /> ...... . ..... <br /> .............. <br /> ............................ .... ....................... <br /> The work to be executed by... ............. ----- <br /> _......._.__. ..._.Plumher <br /> Slate szc of tap. <br /> ..�(/.._Tap to be inserted ir. lhe main. <br /> ...............Nalcr doset <br /> .......�......Bath � .. i <br /> .....Urinal a� <�'� 1 <br /> ........... � � <br /> .___Plain faucet insidc ��R ;,�r,/Y�L�+"5,�,�� II <br /> ._ _ '/ I <br /> ................Si1� �,valk washer Cjtk �<(-,,�+.iE� r�`' <br /> ................Hose Ui6 oulside Mjpjf ': ,..'.'.. <br /> ................Hose Uib fo: building Purposes ' <br /> ................Iiosc bib insidc , <br /> ...............Bib tor slablc containing............._....stelL__......... ._.. , <br /> ... .,._,_._Namhcr of petsons in family � <br /> _..Lf�.._.Numbcr �t rooms iu buildins � <br /> .. .... ._..._. _ .. <br /> The Premises are lo be uscd as a.................__...._._.........._......__.... <br /> Thc o�vncr of ihe premises is........._._...._............._. <br /> .__..__._......_ _......___ _._.. ...._ i <br /> . .._....... ................ <br /> . ..... .........._................................_._.. <br /> Thc asent �s................................ . <br /> This aPP>ication, alt6ou�h siFned, shall not bc binding �•Pon tlic City, until <br /> accepted by the Superinlenden4of the �/ater Department. <br /> SiFned.C�...'..�..•.._�.�...e..c�.!�L(/LL��:.._......._........_..APPlicant <br /> . . ... i��....._ AY......._..........._....... ...........................__..... <br /> AccePted......._._...._....._............ . gup��rintendent. <br /> 1 <br /> � <br /> � <br />