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vl. D. Ferm 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />p�� blan�;s mir_t bc filled in or crosscd out <br />� . ,` ,,• lg. .... <br />Evcrett�.. /., _. , . ...... <br />TO TFiE SUPERINTENDENCIIOY OF EVEAE'�TDEPARTn1EtG �': <br />lalions of lYc V�tCr Dep�artment, for purposes nd <<x�uree �.�tnted b��l i�� ����;"- <br />During thc timc lhat any of thc «'atcr mains moY �� ���en up Lp rc:�snn <br />allcy in� wlii�h t cY maY havc b en� laidetl c City vili�not Uc rc4ui ed toifurni�h <br />ply� may tl us Ue ut o[t, o�be I hblc Por any damages [or�ttsuf lure'so to �do <br />i <br />i , �� <br />ppplicalian No... ........_ ... .........__..... <br />:.ol_ . .._ . Add � ..__ _.. � <br />Block..... .... _ . ..,. _ <br />�. / . r 9 � -�' ' ��._._Slrcrl <br />,- ; ...... ....... � . <br />� � � � ... r�'../::. ! <br />ho...�__.. � . <br />._...._ . . . .. . . _ . <br />... . ........._.............._ Plmntrr <br />. ._....__.....__. <br />Tlic work lo Ue exccuted by..........-....--.......... <br />:;tgic �izc a[ tap. <br />�'' . Ta 'o be inscrted in lhe main. �� ,�� <br />f._ i� <br />. Natcr closet <br />. �../��'....Batlt <br />.� <br />.....Urinal <br />..._...... ... ' <br />_ _,._,......Plain faucet insidc /�'� ���� <br />_...Sidc �valk washcr � ! <br />. _...... � ��, <br />i.`, <br />...,,,.,...iinse bib ouLsidc . � <br />.............Hosc Lib for buildin6 Purposes � ' <br />, _............Hasc Uib insidc � <br />__............IIib for slable containing._._._..__..._stall.........__. .. <br />� _..._.......Numbcr ot persons in tamily <br />�� �. ......Numbcr of rooms in Uuilding , <br />'1' �Ite Premiscs are lo be used �s a. a. � '��-�� � �- ��' � � �-�� ��� <br />. .�°'�� . �/..' . .. .. <br />i <br />'1'hr, owncr of thc premiscs �s .... � �+•�-- <br />_ _.. <br />. ..._.__._.. _. . <br />'I'hc aEcnt is...__.__...._........... <br />._...__.......__ ............._._........... - . <br />•Cliis applic:ition, althnu(�h signed, thall not bc hinding upan lhe City, until <br />;;c, cp!cd by ihe SuPerinten�l o[ the Naler Department. <br />� ' . .. , - . . _'_ArpLc.�m <br />� Si�ned'� ..._._....... .. ..__.. <br />._._�...w : _....... <br />r'r.rrpted.__ ... . . ......_.....1R....... I3t� ._ _.._.. .._._ . tiup�.�rin6 �i;l� nL .. .. <br />