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f= i ,�-y- <br />� <br />:�- <br />W. 0. Form 4 1.:�' .� /,� <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATIflN FOR WATER � <br />All blanks musl be tilled in or crossed out <br />i <br />Evcrett,..__ ......................l�Y��::...........�...................19��..;�.. � <br />TO THE SUPERINTENDENT OF THE WATER DEPART�fENT: <br />CITY OF EVERETT: <br />I hereby apply for thc usc of water in accordance with the ru]cs and mgu- <br />lations ot the \Vater Department, tor pm�poses and tixtures staled bclow. <br />During the time lhat any of the watcr mains may be taken up Uy rcason <br />of any improvements authoriaed by the City of Evcrett, in or of any strect or <br />alley in which thcy mny havc Ucen laid, the City will not be required to furnish <br />watcr during the progr�ss of such improvcr.�enls to any consumer tvhose sup• <br />ply may thus bc cut oft, or bc liablc fo: any dam�gcs for its failure so to do. <br />�(iC�c <br />APPlicalion No.....�.5�.0.........�............ � <br />IIlock ......../.............................._.Itiot....�.'. `'�.: ��..N..�.s .�(.i. Add.....:j '?..zt..c�;>.. _� .11_lGl: ! - <br />No............L.-_�.�._� ........:.:r.':_-cf..�G'L.�.'��....... _.........Strcet <br />...........................................................................�....../..................................................................... <br />The work to Ue executed Uy ...........„��`-?�f7S � _..........PlmnUcr <br />..... ___. .. ....._.._.._.... <br />Statc sizc o[ tap. <br />..j�y ��...Tap to bc inscrled in thc main. <br />................Natcr elosel <br />....... �........Bath y�-qe <br />Urinal 1 � � � ��f�. :;� <br />................ � 1- <br />...............Blain Caucet inside ; j � , � .. <br />__............Sidc walk washer <br />nEc �'sQ�' ``, <br />Hosc b;b ,��tsiae ���y of �vetett ' <br />Hosc bib for building purposes ��T�R pEpT.. �. <br />................Iiosc Uib inside . —`-.... - ' <br />....._.........Bib for stablc containing ...................stall. <br />........._.. .._. <br />._ .............Number of persons in familp <br />:- i <br />...._.. �._....Numbcr of rooms in Uuilding �.% � <br />The premises nre to Uc used as a....... _......�`�`r �`�� -� <br />..._..._.__.__. . ....._. ... <br />.... _ . . _.... <br />The oa�ncr o[ thc premises is_.... _.... ._ .._ � �.4'. . �L . <br />. .. .. _.... _ _...... <br />TScagent is.........._ ....................____......._..................._...__... <br />.......__.......__...__._..... <br />This applicatinn. atthou�ly� �'Fned,�h.7�Rnp lbr binding upun thc City, until <br />accepted by the Superinten¢¢fi . tfi . 6r pep:trtment. <br />// / // <br />�-- <br />Si„ncit..—.._(�r__ ............. �.�.:"`�.-S'-��_.._.......APPlicanl <br />ArcrptccL..__. _....... _.__..1°....... I3}•.__. <br />........__... _._...__..._ __.......... <br />Superinlcndent. <br />