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,. � /� ' /�� . _� <br />W. D. Pom 4 � , �' i <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLIC�4T�ON FOR WAT�� <br />All blanks must bc filleri in or crussed out /- <br />/ <br />r <br />/ .. <br />� , . „ <br />Evcrc� t....... _... �_ _.. .:.:.. _. _. :_.._. _....... �."_ ................... __...19 _... _... <br />T'O THF. SUI'ERIN7'hYDENT OF TIIE NATLR DEPART711ENT: <br />CITY OF �VSRETT: <br />i hereby apply tor thc use of �catcr in accordanee �vith thc rules and regu- <br />]ations of the \Valcr DePa�•tment, for purposes end fizturre staled Uclow. <br />lluring thc timc that a�y n[ thc water mains may b� token up Uy rcason <br />of any imp�ovements autnorized Uy :he City of Everett, in or ot any strect or <br />allcy in �ahich they map Lave Ucen laid, thc Cilt� will not be required to furnish <br />•.vatcr during thc progress of such improvcmcnts to any con,umer �el�osc sup- <br />ply may thus be cut oft, or be liable for any damages for its failmr, so to do. <br />��r�:_ � <br />APPlicatior. No.........' ............... ............. <br />Block._ .................._................ LoL..._...._.. ._. Add.. . <br />�- _� � __ . .._.__ .. _ _. <br />Ne.._ l` i <br />_, .... �...... _::�t . � . <br />�.... .... Slrccl <br />/�'� . <br />/! ,7/ .. <br />..... __ . ' ... .. / :.. �' _ � l...r ..... ..... .... _ . .. ......_ . <br />The wm�k to be cxecute b � 3 z /f%J�l'j �� � <br />Y . . ___. ..._ ._. .. Plumbcr <br />Sla�c sizc of lap. <br />c i/ <br />y._...._.Tap La Ue inscrted in the main. •� � <br />_........._...Water clnse[ `. _,.L�... � . . <br />.. ... ..B:li�l � <br />.. ♦ /.C'/.'r') �{, <br />_ ... ..Urinal - �.. !-'.� <br />.. . ..Plain taucet inside � l <br />, ..: <br />.� � <br />--. -...___Sidc wa1K washer -,,,,� <br />........._.Hose biU outsidc � ' � ' <br />� ' <br />. .._. _Hosc Uib far buil�ing purposes � � <br />� <br />.._.____...7Iosc bib insidc <br />......_........Bib tor sWblc conlaining ............._....stall........__.. . <br />� ._............IQumbcr o( persons in familp <br />._. ..._...._Nmnbcr of rooms m Uuilding �l— � ' <br />v <br />'ih� premises are to bc uacd as a. !_ ��,,`; � <br />yy- � _. <br />Thc owncr ot thc premis�s �....._. � <br />_ �.G�S.t..l <br />Thea�ent is....__.........._....._........___...___.___..._........._....__..... . . <br />_...___.._._.._... <br />1'his application, althou�;h signed, =ha11 not be binding upon the City, until <br />�cepted by thc Superintendent ot thc A�atcr Department. <br />X-i � � v� �--- <br />�� � A <br />3i:�ncd � w.�..:f.....0 � . .:;.,.... /.�..:...:.. ' � ' . <br />...__...��. - . . pplicanl <br />-lcrrp'.cd._. . _�. _.19._.... I3v... _._ <br />-. , ._ __. __.__.___..... <br />, _ . __.......__._.. <br />, . � � Suparinlondenl. <br />