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W. D. Farm 4 <br />CITY OF F\�ERETT—WATER DEPARTMENT <br />, APPLICATION FOR. WATER <br />� All blanks must 6e tilled in or rrossed oul <br />� � i <br />., Evcrett .......................... ......... ........��......................_ _...._...19 _. �: �y <br />� TO TFIE SUPERINTENDENT OF TH� �i'ATER DEPA2?T�fENT: <br />CITY OF EVERETT: <br />�� I hereUy apply for the use ot water in accordance with the : ules and reyu- <br />lations of the Watcr Departmr.nt, for purposes and ti�tures stated below. <br />� During the timc that any ot the water mains may b^ taken up by rcason <br />of any improvemenis authoriz�d by thc City ot Everett, in or of nnv strcet or <br />�? alley in which they may have bcen laid, the Cily will not be required tu f�ntish <br />. water during thc progress ot such improvements lo any consumer tvhosc sup- <br />ply may thus be cut o[f, or be liable tor any damages tor its failure so to do. <br />� APPlicationNo....�d...�.7_f ✓Ja�,_.-�.�— (_ c,'�a <br />............. <br />�'� Block .............�....................... Lot_........>:,J. ..........;........ Add......_.._._ _................ _.... <br />, <br />, I.`�'./..,3 . _ ........................n.,.::. , <br />. <br />xo. . ... . ser��i <br />...... ... `7f9 c � -is r �� i � <br />.. <br />___. <br />�; The wo�•k to Ue executed bv. .. .._.... .. . Plumbcr <br />� Statc size ot tap. <br />-�.r...Tap to be inscrled in Lhe mnin. <br />.. �..........Nalcr closcl • <br />, 1.......Bath � ' . ' : , _ ..;. � <br />_ ..... , <br />.= � ............._.Urinal <br />'.� ................Plain faucci insidc <br />................Side walk waslmr <br />:' � ...............Hose 6ib oulsidc <br />; ................Hr,� biF for Uuilding Purposes � � 7� <br />...............Iiosc biv inside � '� <br />................uiU (or stablc conWining................_.sta11.....J....... _.. L <br />� ._....._..yNumUer o[ persons in tamily �'. <br />� ���.'.5_..._A*umbcr ot rooms in building <br />r The premises are to 6c useG as a_ ................_. <br />... ...... _ _ _ _ . <br />_ <br />Tlie owner of the premises is....._. _.........__........_ _.. <br />� � '' � <br />t�?<<� <br />C/�''�� S � <br />.___._._.. .. <br />__..._. ... _._. <br />TSc �grllt is__ ......................._ . <br />...___...__....__.........._.._......... __......___.... <br />Tliis application. althou�h signed, shall no� he Linding upon the City, until <br />:icccpccd by the Superintendent of the R'ater Uepartment. <br />S i ttned... _ f.. _. N.a-.it�,:. �.t[_i..'G�.i. �. _� i�r i.�.}. o........... _.Appl icani <br />A�_ci�p:cd . .. .. . . .1�. _ Bv ....... ... ...... <br />. _.. . . . . . . . ......... _.... <br />Superinlrndent. <br />