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/i ��-'� <br />,, <br />W. D. Foim < <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must bc fiiled ia or crossed out <br />/ — <br />: : . . ,.. ., . ' � �.../..__t�J_..._.. <br />Evcrett�..........�!-..�.... . .:.._...._..... y.......... . . <br />TO TI3F: StiPERItiTt'*'DENCIOY �F EV RETTDEPARTMENT: <br />I hereUy apply loc the use of waler in accordance w�ith the rules and regU- <br />lalions of thc lVaicr Departmenl, [or Pu�Poses and fixiums �eated Uelow•cason <br />Durin6 «�c timc that any of thc watcr mams may bc taken up bY <br />o[ any impro'^-ments aulhoriud by thc City of Eerrcit, in or of any strcet or <br />alley in which lhcy may h�ve been laid, the City wi11 not Ue required to furnish <br />P��t� Yu�hu bc u[ ottsor be,liaLlcforVany damages for itsuf lurc�so to do. <br />. APPlicationNo.._%_L-..::�.f_..........._.. <br />i.oi _ . .. . , n�a _ _... .. .. <br />Block... . . . ... . _ __. <br />� ) �� . . � "� _._..Strcet <br />r ' � �..��.. t..._( ... <br />i%/ 1 <br />No..._ � .. . ... <br />. _ ................. _ ....................... <br />. . ...................................................... <br />Thc wm�k lo Ue executed bY... _ .......................__ ...___.............._.... <br />.......Plum cr <br />State sizc o[ tap. <br />,:_:,�:.. Tap lo bc inscrled in lhe inain. �rd .� —' <br />i <br />,_........_ \Vater doset <br />.......�... 13ath <br />. i' � t,��`� , : <br />__...........Urmal � l/J , � <br />.._.....Plain fauccl insidc � � ' <br />_ � <br />_ ._._....Side walk wa=_hcr �" <br />11" �`, <br />.. _......._.Iiosc bib oulsidc ; ,'.� <br />. _. ..._....Iiosa bib for buildinF Purposes <br />_. <br />__.._Iiasc bib insidc <br />.__...I3ib for stablc containing..._ ............._stall... _ .._ .. <br />. _....Numbcr o[ persons in family <br />� ...Nur:ibcr of rooms in building � <br />• _. <br />T}�c Premises arn to Uc used as a..._....._'�:.C_�.:._.....___._... ... <br />_ <br />. __......_. ._._..... <br />_ _. <br />Thc owner o[ the premiscs is...._.__. ... - <br />'Phc aSent is...._ .............._..___._. _.... <br />._ .............._......._......_ .. <br />___........___.. _.__... <br />9'his application, although signed, shall not Uc binding upun the City. until <br />acceplcd bY the Superin'endent �oE qtlie �i'���ter Department. <br />fi�ta-_'-�l .� //�RJ� �" r : .t.r__..........APPlicanl <br />Si�ncd � . ....� . ..._....._ __. _ <br />� _.__. ... ._.. <br />Accop:��d...... ...._ ... . .. .1...__ )' ._..._. _ .._.SuperiNcndcnt. <br />