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q,4.j-ft� 1-'-q---4 - P�-1 <br />W. D. Forty /-IE00-F-P.h,.--5-26•24 <br />City of-Fverett--Wnter Department <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />�/ <br />Everett ............. <br />TO THE SUPERINTENDENCE O IEATEVERETT DEPARTMENT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />�.,at any of the water mains may be taken up by reason <br />latiens of the Water Department, for purposes and fixtures stated below. <br />During the timn the Cit of Everett, in or of any street or <br />of any improvements authorized by Y <br />aliey in which they may have been laid, the City will not any on required to furnish <br />mry ti�us ibe i rt ff, oreh�l nhS'�tanyvdamagesents ofor itsfailureso to s do. <br />uPplY <br />9 k.................... <br />Application No..__ ..�'... 1) . <br />Block..................... Lot Lot........._?'.7- .................. <br />Add...(., _� .................... <br />No......,�. ln..I.......%._�.a.Street <br />..................................................................... <br />O................... Plumber <br />... <br />The work to be executed by ........ ......._ ... - ...t = � � <br />Fj <br />State size of tap. JI �i0� <br />._2,.....Tap to be inserted in the main. <br />:/....... Water closet <br />1.......Bath <br />.....Urinal <br />....... Plain faucet inside <br />.,....,, ....Side wall: washer <br />,.,._..1,......Hose bib outside <br />......... Hose bib for building purposes <br />r <br />lAN S) 1926 <br />CITY OF EYER b1Ti i C'_?'T <br />13V. ........ x * " * .......... <br />...... ,...... Hose bib inside <br />-,-.-.....Bib for stable containin g....................stall.................... <br />,...Number of persons in family <br />,..,,17Z ...... Number of rooms in building <br />. ate: .... <br />........................... . <br />The Premises are to be used as n................ <br />The owner of the premises is............ <br />......................................... <br />'re agent is .......... ....... ... ........ ..... ......... ............ ........ <br />............. until <br />nplication, nithcugh signed, shall not be binding upon the City, <br />the Superintendent o the Water Department. <br />licant <br />Signed... .............................................. <br />................... <br />.................. <br />.-..�Z. —..........102�U. BY... .. ... .. mtende <br />