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,�� <br /> W.�. Fo�m 4 `��1_ <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLII.;ATION FOR WATER <br /> � Ali blanks must be filled in or crossed out <br /> ,� � � r�` 1; ' 4 .,, . -. — i <br /> � <br /> +�1 1� l,e.: r { ,.:. ' Evcrclt,......_. ...�.r<-�';:../C.�. ... .... _19l'.�.. <br /> ���- ��� � � TO THE SUPERWTENDFNT OF ""iE WATER DEPARTh4ENT: <br /> � � � ' � CITY OP EVERETT: <br /> I hereby apply for lhe use nf water in accordance wilh the rules and mgu- <br /> lations of thc \Va�cr Department, for purposes and tixtures stated below. <br /> Durin� thc timc that any of thc walcr mains may bc taken up by reas n <br /> of any improvements auUiorized by the Cit.V of Everelt, in or ot any slrect or <br /> alley in which they may have been laid, lhe City will not be required to furnish <br /> water during the progress o[ such improvements to any consumer whose sup- <br /> ply may thus be cut off, or be linUle tor any damages for ils failure so to do. <br /> + .� . . . �"4.`'e?,;q�7 ':_� ,..�-. . . Applicalion No.... . � ..�.......... <br /> � ��.% <br /> :,'�'�_,� • . . <br /> �. � . . : Block........................................ Lot..........�.....p......................... i,dd....___....__._...........__....... <br /> � No..........��/l..�4."4.-..........��c�?�I��E�c:....—..................._..._.....Slrcet <br /> / <br /> � ..................................................... ................................................................................................ � <br /> . Tl�e work to Ue execuled by......................__......._._._................_...__..Plumner <br /> . Sl�a,�l/e sizc o` tap. <br /> .../,fY.....Tap to be inserted in thc maia . <br /> ._.__........�Vatcr closet <br /> �� �>. <br /> ....�....--.Bath �T- <br /> � <'n � � <br /> .__---__...Urinal ��z }i, <br /> i f ,J/,",, <br /> ...._....__..Plain [aucet insidc � C�� Gt j� �,J,(F� `��� <br /> ...........Side �valk washer q� ""� /FW <br /> , ���, � ' �; <br /> _ .. � <br /> _.............Hose bib outside . '�� � // /� <br /> .___..__....Hose bib for building purposes � ��DT✓ ��} L�Y � 4' <br /> . �� i,' <br /> _..............I�Iosc bib insidc � <br /> � <br /> / � <br /> ....._.........Bib for slaUle conlaining.................._stall. .................. `1,�/ C� ,(�Y <br /> � <br /> ........_....NumUcr of persons in tamilp �� �c'� a� , <br /> P' <br /> �: <br /> ._.�...NumUcr of rooms in building � �' r ��,�'� �q ��S <br /> 7'he P�•emises are lo Uc used as a..._......_............ . .............._.C..y..Y, . �t�`./,ff� <br /> The o�vncr af thc P�'emises is..... __..... . . .. �✓ . <br /> . __ . ........._ ......._ _ . __.. <br /> Theagent is...................._._.....___.._._..__._..__._._..........__..............__..........._......... <br /> Tliis applic�tion, althouFli signed, �hall not Uc binding unon thc City, until <br /> :iccepted by tlm Superinlendenl 0[1}1�.R'a�l��;r Dep/arlment. <br /> Signed.l.l.22�?. "..`�...1..�..SZf.(,%�.x.�'r.�:a:1�.�2L%,C:.'........Applicant <br /> Accc�;eu._.. . .. ......_. _ _.. .._..19. .... Bp_. ... ....__.. <br /> _ ......_...... ................ <br /> StlPcrinlendcnt. <br />