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/�./� - - <br /> w.o. Fo�m a ' ' <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATIOI�t FQR WATER <br /> All blanks must bc ti]!ed in or crozsed out <br /> Evcrett�........_._...._._._..�.:� i ..:i./................__....19.:.c_•t:� <br /> TO THE gUi'ERINTENDENT OF Tf1E �5'ATER DEPARTil1ENT: <br /> CITY OF EVERETT: <br /> I hereby apply (or lhe usc of �antcr in accordancc «dth thc rules and regu- <br /> lations of Uic Nater Dcpartment, for purposes and fistures stated belaw. <br /> Dw�ing thc timc tt�at any o[ thc watcr ruains m�y bc taken up by rcason <br /> nf ;�ny impro��emcnts authorized by Lhc City of Everetl, in or of any street or ' <br /> a11ey in trhi:h thcy may have bcen laid, the Cily q,ip rot be required to Curnish <br /> �vater durin8 the progress of such improvements to any wnsumer whosc s�ip- <br /> P�l' may thus be ut o[t, or bc liablc for any damages tor its failure so lo do. <br /> APPlicatio� ....����_�!:(............ <br /> IIlock........._.�='......_.........._.._ Lot.........�� . <br /> ..__............. Add.cl;t; �—«t __... . <br /> No......._�:.t.�-�c..-...._.1��- . ..-._. /. <br /> .._....._....._......................................_..... ......_.Strccl <br /> ..... _...._................................._..........._....................................................._..._._....._........_...._. <br /> Thc «�ork lo he executed bl'��-._........._...__._..._ ._. Plwnbc <br /> ....._........._ ._. . .. <br /> State sizc ot tnp. <br /> -_✓,l`c::.Tap lo bc inscrted in Ihe main. <br /> .............._�Vatcr doset <br /> i % <br /> .._-.........Bnth <br /> ................Ur i n a I . <br /> .-.-_........Plain faucet insidc , � % � " <br /> �nL�' /1 <br /> ............_..Sidc tvalk tvashcr . : "^..'/� " � <br /> �. <br /> . -......._._Hose Uib outsidc � `� � - <br /> --............Hosc bib tor building purposes ,':. <br /> -.-...........Hosc Ui i inside <br /> .-.............IIiU for slaUlc containing._ .______ .st.,l!_ . __. .. <br /> � �--.........Yuuibcr ot persons in famil}• <br /> ���-�.........Numbcr of rooms in building <br /> 'Chc premises arc to bc used as a......_.... <br /> TLe owncr of the premises is__._...._._ .. .. .... .. .. .. .. ... <br /> 'Chc agenl is......._..._..._......._.. .. . ... . .. . . . . ... . _. _ . <br /> .__._ ._._._. <br /> . ._. _ . ...._.._.... <br /> ._._._. . . ........_ _.._... <br /> 1'h-� �ppl-c;ition, although signed chall not bc bind:ug uPon lhc CitY, ���til <br /> oceept«i b� llic Supeiln�ndent ot the R'atec epurtmene. <br /> Si�.ned.. ....���� ' ��' �� _. ��.:..�i ,� ..., <br /> ._.....:. ......_..\_............Applicant <br /> :Accap,c.l . . . ..__.. .1!!._ .. 6�'...�. <br /> . .. .... . ... ... . __........ <br /> Superinicn,lonL.. __. <br /> �.T <br />