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/ <br /> r � . _ — <br /> w.a Fo,m a <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATl�N FOR WATER <br /> All blanks must be filled in or crossed out <br /> — <br /> Evercll, _...._..... ... .Y:.:_.�. .._......... ..._........19�._�/ <br /> 1'O THE SUPERINI'ENDENT OF TFiE R'ATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hcreby apply for thc usc oC walcr in accordancc with thc rules and mgu- <br /> ]:ilions n[ thc Walcr Department, for purposes and fixWrcc stated Uclow. <br /> During thc timc lhat any of thc watcr mains may bc taken uP ��Y rcason <br /> af any improecmenls aulnorizcd by thc Cily of Evcrett, in or ot any strccl or <br /> ;�lley in �ahirh lhcy may have Uecn 1aid,the City will not bc required to furnish <br /> «•ater dut inG ���� D�ogress o[ such improvements to any consumer whosc sup- <br /> ply may thus Uc cut off, or be liable for anS damages for its faiWre so to do. <br /> i d � r <br /> Appl�calion No i �C..�� �.� v� � . �,1� , . <br /> � ., .. � <br /> i3lock.... _..._....f!.�.k�Lyf /"_d. _ %!.�.!Add��._, . ..�( c.c_ .: <br /> No._......_.,��...�l.:.L.�:....C.._..._'a.....�.��....._� c.«_..�.�..`_ti.—�......_Sirccl <br /> ._....._.._._._............................. ._......._....................._.................._...._.................__.._......_....... <br /> The work to Ue executed by.. ...........___._. .. .___.._.__..........__....._......Plwnbcr <br /> Stalc sizc af tap. <br /> , .i <br /> :.............Tap lo be inscrted in the maia ��-'�� <br /> ..._.._.......Nalcr�;locet d �, . • .� . <br /> -..�et�i � / <br /> < <br /> .. ...c.:._ � . ' <br /> �� <br /> ................U r i n a 1 <br /> ...__.........Plain [aucet inside <br /> .__._. ... Sidc walk washcr �. <br /> _.�]Tose 6ib oulsidc .���'-' � ' ' �- — <br /> . ..�.__...Hose Uib for Uuildin � <br /> _ g aurposes , . , , <br /> , . <br /> .____. .__lius^ biU inside ' ' <br /> ...............IIib to: slaUle rnntainin5..._............._stall..__......_ .._. <br /> _.......NuNbcr ot persons in family <br /> ��.��._�.���.Nuir�bcr ot rooms in building <br /> The premiscs are Lo bc uscd as a....___._............._............_. . .. . _ . .. .... <br /> 'Chc owner of the premises is ._.___. ____... ........__... .._.._. .. _. <br /> Tho agent is . _.__......... . _.. __ .__._. .. . . <br /> __.. .. _...._._..._ . .... <br /> 'I'liis :ipp!ic,�lion, althnugh signed. shall not bc Uinding upon thc Cily, until <br /> acceptcd b>� 1!�,c Superintenden! of the R'ater Departnent. <br /> /— : -, /� �.) <br /> SiF:nefi 7.�..._t�._...:.�,..,._1�C;Vad.M.. ._....__....................App]icant <br /> :Acmp:�' . . _ . . .IP. . Rp. . ... _ .. . . <br /> . .. .. .__. _ ....._. <br /> tiupr:�inlrndaul. <br />