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/c; _-. <br />w. o. r��m a <br />CITY OF EVERETT-WATER DEP�.RTMENT <br />APPLICATIC►N FOR WATER <br />All blanks must bc filled in or crossed out <br />Evcrett ............. �' .'..,.`:.� `� � `"............................19 �'.:'�. <br />.._..__. ._......... . <br />TO THE SUi'k;IiINTENDENT OF THE WA1'ER DEPARTMENT: <br />CITY OF EVERF.TT: <br />I Hereby apply for the use of water in accordanee with the rules and regu- <br />latiens o[ Lhe Water Departmenl, for pmposcs and fixlures stated 6clow. <br />During thc timc that any of thc wstcr rnains may bc taken up by rcason <br />ot any improvements authoriud by the City uf Evcrelt, in or of any street or <br />allcy in which they mal' hace been laid, the Cily will not be required la furnish <br />u•.�tcr durin�; thc progress of such imPruvcments to any consumcr wliosc sup- <br />ply may lhus bc cut off, or bc IiaUlc for any damagcs for its failure so lo do. <br />Appliration Nc.....1...^�,:� %, t� <br />. _..... � ............. <br />� ..1� <br />IIlock............._.........................I.ol......._......_...._...._....._... Add..C`_c�.s-,.z-dc1.-.-,.�.. <br />No............_J'cf'.�._-:?�..:..-:.��.��...��'.=_s_c_ ................__....:...........Slrecl :� ,:.. <br />7'he work to be executed by .........................__.... .._ ... .. .... _ . Plumber <br />Stale sizc ot tap. <br />;;��....Tap lo Uc inscrted in the main. <br />Water dosct <br />.__..i...... � � ., <br />_�....Bath d � � �.. <br />8 4. � ,- <br />.....urinal ^-� - <br />,I ;, �: <br />...._..�...._..Plain fauccl insidc 'IQVIO r��, �/�� ] <br />_. ._.... Side walk washer ' � ' + <br />w i(y of Ft: Z.r `�c <br />� , <br />....Iiose bib autsidc - r <br />............Iiose bib for buildin A�R ��,", � i . <br />._.__ Cpurposes �� �, i� <br />t - <br />.. . ._.......Iiosc bib insidc . `� <br />.. .__......Bib tor stablc containing_ _..._ ..... =t:�i1 . ..... <br />.. .._.. Number of persons in familp <br />��..Numbcr of rooms in buildinp <br />'Phc premises are lo bc used as a_ . . . . . . . . . .. <br />Th� owner ot the Premiscs is....... ._ . __.. _._.. .. .. . . _. ._ . <br />'I'hc agent is..........._.._ ............................................_.................__....._...__...... _......._.. <br />l'hs application, althnut±h signed, shall nut U binding upo the Ci.y, until <br />Sitine :. d. f the% Water >arUnen�. <br />eseptcd by tls S�crinlcp�/ / „f.....�...,..._.'........_.._...___.......Applicant <br />. ` <br />\,.ci�p.ed.__ . . _._. __1�.__.. By .__._._ . ..._._............ _.. <br />_ Supurinlendcnt. <br />