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_-. . i c. N. <br />�ITY OF EVERETT-�Water Department <br />Application for W ter <br />All blanka musl be filled in or cro%Scd �� <br />rf� <br />f,��««._-___ .�G — - ---.�9�. <br />'PO THE SUPERINTF.NDBN7' OF TH ATER DEPARTMIiN'C, <br />CITl' O � EVERE7T: <br />1 hereby apply ter the use o( water in accordance wilh the rules and regula� <br />tions id "Che Water U�Dartmnnt, for pur{mses and fizturrs stated below. <br />DurinF �he time that any nf the water mains m�y be taken up hy reason of <br />any in:pruvemenis authorized b5 thr City ut Everett, in nr n( any strcet �tt a��ey in <br />which they mny have heen laid. thr l'ity will nnt be rcquired to lurnish wa[cr during- <br />the pm¢ress n( such improvemenw to any consumir ahnse supply may thus be cul <br />nB, or be liable for an�y Jdam�g�e7s (ur ils (ailure so tv du. <br />' ApplicaLonNn...(_�?.,Z'�__'__3�r <br />Rlodc.'_£:3�Q� _'_ ��,L,,_�'�_'"_�"�/"_�__""Add'_"_"__"_""_'"' <br />No.._ �-rd!,�'"1_�`�-"i!--`^'-`.'_""'_..Strect <br />�R/%-----'-- � ----'---- --------"-----_.""--. <br />---------'---- <br />'fhe work to be executcd by-_-_._____..-_ ___.- Plumber <br />__._.___.'_____' <br />Staie /s)zc o( taV� �/� U �_ <br />___/�_Tap tn bc inserted in the main. <br />_ _ _ _ _ _ _. _ _ NalCi dosCl <br />' _' _' _' Ralh <br />____.'__ .Urin�l <br />____.___ _Plain faucetinside <br />___.____-Sidc walk washer . <br />""__. _Hose bib nutside '. i <br />-__.Hosc hib (or building Purposcs � ..•� <br />__Hnsc bib inside <br />__IlibforstablecontaininE------..-_�talL".---- � ��:'�, �I �/ <br />___ ____Numbcrofpersonsinfamiy' <br />"_'___'Number nf rnoms in buildiug <br />'Phe premises are to be used as a.. _. ----'--'—"- �--'--------- '-"" <br />'Phe owncr of the Premises is . _. _ _ _ .. _ _' _ _.. _ - _ - -.. _ _ _ _ _ _. _' _ "_""' _ _" <br />ThcaKent is. '__'__._. _._. _'._'_""--'_ '___'_ '____"__'_'_"_"___"_ <br />7'his �pplicalion, T��hnugh siNned, shall nol be binding upon thc City, until ae <br />d by The Superintendenl o( the 1i'nter 1 artmen . <br />SiRned. �--__ ' - __'_ ____'____.ApPlicant <br />.. '___. - <br />_ _' _' <br />.iep�ed. ___ �-��--/-�l'"-'--��3 �;Y-�""_"Sut'erimeneem <br />� F ' � <br />