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� <br /> W.D.Po�m d <br /> CITY OF EVERETT-WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> AII blanks musl be tilled in or crossed out <br /> Evcrett�... . . .._.._.._ ���.__.:r � -� _...19_5.:: • . <br /> 'f0 'CIIE SUPERINTENDENT OF THE \VATER DEPARTb7ENT: <br /> CITY OF EVERETT: <br /> I hercUy apply for the use af�vater in acwrdance a�ilh the rules and regu- <br /> lations of the 1Vater Dcpartment, for purpascs and fixtures staled below. <br /> During ils timc lhal any �f lhe watcr mains may be taken up by reason <br /> ef any improvements authorized ny ihc Cilp o[ Evcrelt, in or ot any street or <br /> nlley in which thcy may havc been laid, the City will not be required to furnish <br /> �oater during the �rogress of such improvemrnts ro any consumcr whosc sup- <br /> ply may thus bc cut ot[, or be liable for any damages tor �ts tailure so to do. <br /> � -� �S " <br /> Applicalion No...:...�`._...L....:....._........... '-- . <br /> � ��, ��., � . ., <br /> Slock......................................_Lot:..,_...._._,r.�..:"r...__....._. Add_�.......,._j._..y..�....,..�._�. <br /> No..............�....iF..:.'.:�_:._....._..,.__ES...i..i.,;..�..�2'_.L...L..,;:..Li,�:L....._.....Strect <br /> � __._..__.__..............................._....._.....................__................___...._.._---............................. <br /> 'i'hc work to be exeruted by... ....._...._.... . . . . . . .._. . Plumbcr <br /> St�tc sizc ot tap. <br /> ..._....Tap lo bc inseried in the main <br /> _............Watcr closet <br /> . ._..........IIath � . <br /> . _......_.Urinal !�7�� � � '� �� <br /> c � .; <br /> _ .._.........Plain faucet insidc !ir'T G� t�J.,� �� . �, <br /> . ...........Side walk washer ,-,.,�,,,/_• . � <br /> ' ._.........Hose bib oulside ' . ' "- ' �� <br /> 1..1: =.2 : . <br /> . ..........Fiasc Uib tor building purposes <br /> . _ _._.....11ose bib inside <br /> _ . ...._.....Bib tor staUlc containing...................stall_.........._ .. <br /> . ._...._......NumLer of persons in tamily _ . .� , , <br /> . . __......Numbcr o[ rooms in building . ( � � ,�. �;� � . <br /> 't9ic premises arc to Uc used as a.__.... " _._..... ......_.... .... .. . : . <br /> 'i'he owncr of tlie Premises �s._......._.__. ..__......__. ...._......___�-�, ;._'..,:4�'..,. <br /> � , <br /> '1'lic a4:rnt �s... _. ......_..... _._. ...... .... .r..,..i�..rc.r_e_C_ aY.:..,..;.._...._. <br /> 'Clr_ nppl:r:ninn,allhnuFh signed, shall not bc binding upon thc City, until <br /> nrrcp:��.l b�� ;h�� Superintendenl of the ASatur DePartment. <br /> iI _ , . ,oc � " i .", [ <br /> ��„ncd.. .:.....��.. . �� ..:.._._ ....._,... ... ............__.P.pplicanl <br /> t <br /> .1��r��p:i„� . . l IR. .. lic _ .. . . _ ._._. _. <br /> ' Sup�rinf mlcil. <br />