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1bVILX6 <br />W. <br />O. Form • 1500 3-1.17 C. P. <br />CITY OF EVERETT--Water Department <br />Application for Water <br />All blanks must filled in or crgSked outEverett, - <br />TO THE SUPERINTENDENT OF THE WATER <br />DEPARTMENT, <br />Y OF <br />I hereby apply for the use of water in and iidtu fixtures with t tbebwes and regula- <br />tions of The Water Department, for pure reason of <br />During the time that nn7 of the water mains may be taken up by <br />any improvements authorized by the City of Everett, in or of any street o alley in <br />which they may have been laid. the City will not be required to furnish watter during <br />I <br />progress of such improvements to any consumer whose supply may thus be cut <br />off, or be liable for any dam+ s for its failure so to do <br />r -1 <br />Application No.. _. _-- -.--------" <br />Ill«k---- ---I.ot.-3"�------..Add.-- -�-,(� <br />�� -- -- .......... Street G'�_ _ <br />.--------------------- •.......... .------ .--------- <br />Plumber <br />The work to be executed by---------- <br />Stale ze of tap. <br />s,-'� <br />ap to be inserted in the main. � <br />Water closet <br />---- Bath <br />.Urinal •_ <br />Plain faucet inside <br />b <br />Side walk washer *il.,f L-qt <br />-------- llnse bib outside <br />-----__._.Hose bib for building purposes z^ <br />__-.-_-_..Hose bib inside <br />_-"•------ <br />Bit) for stable containing .------- --- stall ------- <br />=-- <br />Numher of persons in family r <br />16_.Number of rooms in building <br />The premises are to be used as a ---- _ _"............... <br />------ <br />The owner of the premises is ------------------------ <br />•------------------•_• <br />The agent is. "._. _.___.._.. _._.._."................. .... <br />This application, although signed, shall not be binding upon the City, until ac- <br />cepted by The Superintendent of tb Water Department. <br />pplicant <br />SUDcrintendent <br />