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��� .� �" � <br /> w.o. Fo,m a <br /> tITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR �JATER <br /> All blanks must be filled in or crossrd ou[ <br /> < - . .-:�..r'._.............. ....19�:'.�i <br /> Evcrclt,........_.. . ._1.::<.�....�.... . .... <br /> TO TI3E SUI''r::tItiTENDENCIT�Y OF EVERETTDEPARTDiENT: <br /> I hereby app1Y for tlu use o[water in accord�nce with lhe rules and cegu- <br /> ]ations o[ lhc �Valcr Department, tor Purposcs and f�xtures statcd bclow. <br /> Durin�' the timc lhat any uf the waler mains may Ue talcen up by rcason <br /> ot any improvements authoriud bc the City of F.vcrclt, in or of a�q' slreet or <br /> alley in u•hich lhey may liave Ucen Iaid, the City�vill mt t�e required to furnish <br /> ply�may tl us Uc cu�t oft5o�bc liablc foav�e yc��s�a6es for ls fa'lurc�so to do. <br /> Applicalion No...�����..�.—........ <br /> Block.. "?.j........._ Lot ._"2_.... ........._...._. Add 1`+:s��_ .(?�.[�..�.:.. <br /> .. . / � i ...—.. <br /> �� � ,?-ci_......._!/.�1f�¢c..._��':a,<!y.�.../._cC..............Slrcet <br /> No..........�...�..c.. . � <br /> ........................................................................................................................ <br /> The work to Ue executed UY.............._........_.____................._.__. . ... . <br /> Plumbcr <br /> Stal �sizc o[ lap. . . <'C <br /> l ., :. <br /> ,"�_�.�......R'ap to be inscrled in lhe main. , , <br /> ...._.._.....R'atcr doset % u , ,:' <br /> .�i. Ba.th � . ,/ � ,J - <br /> ......_... , , ,j . . <br /> . , „ , <br /> ...._..........Un nal <br /> __.._..__..Y]^:n fa:cci insidc ,1,�1�.�=� �r;�./��-i� <br /> .._.Sidc walk .vashcr V -,�` '� <br /> � <br /> _...__-.-Hosc bib outsidc ': � � `-���,t i,_� ���i . <br /> .. .._ .....Hosc bib for building Purndses��:_:�' ��Pr, �i� <br /> ._._._.Hosc bib insidc <br /> ...._..........Dib tor slablc containing......._......_._stall..._....._.. ... <br /> .......__..-_Numbcr o[ Pcrsons in tamily <br /> ...._G.._...Numbcr of rooms in building <br /> . .............. <br /> Thc Premiscs are lo hc used as a......._................__.................................... <br /> Thr owncr a[the Premises �s. .........._.____._ _.. __._......._.._...._..... <br /> ..__.__.._. <br /> T�ie a�enl �s . ._.. ._ . ......._. . <br /> __.... .......__..... <br /> ... ........ <br /> 1'his aPP��cal�on �lthoaFh siFned, sh�ll not Uc bmdmg upon lhc City, until <br /> aci.epted by the Supenntendcnl ot . V iter Depattment <br /> - <br /> V �ri,C� Lti���'L.A <br /> SiFned...... .._._ �.....__ ... APPlicant � <br /> .._._......._..._... <br /> ._7^.._. L3y. . . . . _ .___. .._....._......_... <br /> Acc��p;cd_. . .. - _ <br /> .-... ...SuPenntrndcnt. <br /> a <br />