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w. o. ta�m a <br />CITY OF EVERETT-WATER DEPARTMEN'i <br />APPL�CATI9N F(JR WATER <br />pli b,anks must bc fiIled in or crossc3 out <br />F.vc.clt�-......._._........_.._ �fe:zs_s..l.....__ _. . 19 � r. % <br />TO Tlil•: SUi'P:il,til�liNDENCITY OF EVFRETTDEPARThf£.NT: <br />I hercUy apply far the use of walec in accord�nce wilh the rules and regU- <br />I:rtinns of ilm tVatcr Dcparlment, tor purposes and firWres stated below. <br />lluring Ihe Cmic that any o[ thc waler inains may Uc laP.en up Uy rcason <br />of anp improvements authorized by thc City ot Everett, in or of any strect or <br />allcy m wh�d� thcy maY have been laid, tlic Cdy will not be required to [crnish <br />pi�� may thus bc cut uftsor be liablc tor�an,vedamagcs tor dsuf lurc}so to �o. <br />Application No..../� � � � �"3--� �-- <br />,fl . �7r1 . -, . <br />i3lock ........_ Lot _.. .. ._ ....._...._. Add.. CP_�2�s+e�-.�n-. . .. <br />_ .........._ - <br />.._..... �- �. . <br />....._..... .. <br />��a�� �/c„G � Strccl <br />:1n....___. ....... . <br />� .............._.............................. <br />. .. . ... . ..... <br />...... .. . .. . ... . ..... <br />......... . .. <br />__ . . <br />. .... ___..._. I'hunLc. <br />Thc ��ork lo be executed 6y ... .......... ... _.. .. .. . - � <br />Statc site o( tap. <br />_�/._ Ta� to Ue inscrled in lls main. ` e�, <br />,., , ....Naicr doset � �'� <br />1�.. ?.-..Bath "� � • <br />G�y <br />.. .___..._Urinal 6'"� ,^. ' <br />. _...__Plain faucet iusidc ' L �!, �" .. <br />. . ........Sidc walk tvasi�cr �//:, : /�'✓���' , ` / <br />...._...Hose Uib oulsidc ' � .�� <br />. . ......._Iiose Uib for building purpos� ��t <br />«r�9� \ <br />..__..._.._I�Iosc bib inside � .�1 ;� . <br />....__.....IIib tnr staUlc conWSning .................._sWll.... __. .. <br />._.Numbcr o[ persons in family <br />l_.. Number of rooms in bnilding <br />1'he Prem';es are lo be used as i_..__.......__..__._.......__.. _. . ._. . . <br />'Cl�.c owner of the Premises is._... ._. ......_.......___...._...._ .. <br />_ ..... ............_.... <br />9'�i aFcnt �s. .._ ....... ........... . .._.__......... <br />......._. .. _.___... . .... <br />ucceP�ed byPthe Supermlendenl of h� �Wate �Depe tment.upon the City, wriil <br />SiGned._...LL�I'-"r° �/�C/-'� ._Applic�ant <br />i � <br />ArrrP;i�:.... . . _ 1... .. _ _.. ._ .._ _�uPrrint -1i.i L. <br />