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W. D. Form < <br />CITY GF EVERETT-WATER DEPARTMENT <br />APFLICAT'I+�N FCyR WATER <br />:11I Ul;�nks must bc filled in cr crossed out <br />f::erett,_. .. . '�� -:+c.�./._......_........_....___.._ ._ 10 � �_r� <br />TO TFIE Slii'13RItil'ENDENT O fiE`WA'fEJi DEPARTn1ENT: <br />CITY OF EVERETT: <br />I hereUy anply for the use of water in accordanec with ihe rules and regu- <br />IaUons of the Naler DeP�rtment, for Purposes aud tixtuns slated Uduw. <br />During lhc timc ihat asy o[ lhc watcr maim: inay bc laken up by rcason <br />n; r.ny improvements aulhorized by thc Ciip of Everclt, in or of an}• strec� or <br />alley in «�hich they may have becn ]aid, ihe City q�il] not be rcquirr.d to furnish <br />�eater during the Progress of such improvements to any consumer whose sup- <br />piy may thus be cul oft, or bc liaUle for any damages for its failm�e so to do. <br />Application No...�'-�.y/........_ _. <br />Ulock ......................................_ Lopt............,�' .....___...... Add.��a:r..c-.i.<.-..i,e:L"� L'.�,� <br />�'.f%o..�'...5�`'t!.�..2_.._...._ ....................._................Strect -`,._ <br />�'o......_._.......... ._ .. <br />.. ._._._ ..................._......_.._..............................._.._......_... ._.__....___ _._....._........_. <br />The work to Uc executed by_. _......._._ . . . . Plumbcr <br />;tale sizc o[ tnp. <br />.�/t�..1'ap to be inscrled in thc main <br />._._....�Valcr dosct , ? �' l <br />... �� =•�.. <br />r <br />/._......Baln /j �// : <br />/ <br />......Urinal � { <br />.....Plnin taucct.inside �/ � <br />. . _.........Side walk �vashcr <br />_.._......Hose biU outside <br />.._.....Hose bib [or building purposes <br />. ....___I3ose bib inside <br />. ____...11ib for stable containing .............._.._stall.____ ._ ... <br />.___ NumUer of Persons in familp <br />.� ..-NumUcr of rooms in building <br />�!'i�a premises are lo be used as a_...__..__..._...._........._.._...._ _.. ._. _.. ... <br />..-i�c awncr of tl�e oremises is. _._.._ ............_.. .___..._.._........_.. _ . <br />'C:ic aScnt is.... _ ._....._.._.. . .._........ __.........__............_._......._..... _... <br />This application, althnugh signed, shall not be binding upon thc Cih�. until <br />accepted by tiie Superintendent of the Waler Deparlment. <br />SiFned ✓�...�'..li'�^,�....,y�.....�-� `,... Applicant <br />:A�r•p'.�,1 . . . 1�. ... El� _ � _ . _ __.. <br />Supu�iutrndcnt. <br />