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. <br /> ;� <br /> W.�.Fo�m 6 <br /> CITY UF EVERETT—WATER DEPARTMENT <br /> APPLICATION FOR WATER <br /> All blanks must be filled in or croxsed out <br /> `j � � i i <br /> Everett�..................._....,^�_....__._........_..._.._.................._19_C^.l <br /> '1'O T3IE SUPERINI'F:NDENT OF TIIE WATER DEPARTDtENT: <br /> C1TY OF EVERETT: <br /> I hcreUy apP�Y fc� thc use of water in accurdancc with the rules and re6u- <br /> ]alions o[ the Nater D�pnrlmenl, tor purposcs and fixiures slated below. <br /> PurinF the timc lhat any oC the watcr mains may Uc taken up by reason <br /> ot any improvemcnts authurizcd by thc City of Evcre(t, in or o[ an}• street or <br /> allcy in which lhcy may have been]aid, the Cily will not bc rcquirrd to furnish <br /> �r:rter during the progress ot such imProvements to uny consumer whose sup- <br /> pl}� may thus be cut ot[, or bc liablc tor any damagas for its failure so to do. <br /> /�J"�f� �' � ' <br /> Application No......................................... . ,- <br /> «< :� , 0 5 <br /> f3lock........ ...........................Lot) � ��_._. ... ._ . .\dd! .._,� ._ ....... <br /> xo _.�.�,_2. 3....]......_lL..:C4..£,.�i,.,c..l ( C�,r. Strcet <br /> _........................._......................_..............................._ ......................................._... <br /> 7'he work to Ue execut�d bY_. ..........................___._....._.._..................__Plumber <br /> Stoto size of tap. <br /> , . .._..T:ip to bc inscricd in lhc main. � r n <br /> .� . _.....Walcr daset '- ,� e ��{�. <br /> '' a <br /> . ._.__.....Bath . /C/.: . <br /> . . _ ......Urinc l �::I.�i:q'�'�� . , <br /> .. ... ....Ylain faucet inside . .�rY � "� �� :« <br /> _ <br /> .. ._.....Sidc walk �vashcr � ` .� ; _ <br /> .. � . , .-- � ;-_j <br /> .__.._Iiose 6i6 outsidc � � � � <br /> _...._.Hosc bib tor building purposes <br /> ... _........Hose biU insidc <br /> . . .......Bib for slablc conlaining..........._......stall........_._. <br /> .___.NumUcr of persons in tamily <br /> ..._.Nmnbcr of roams in Uuilding ' 7•�,' �/ <br /> 7'nr 1-,rcmises arc to Uc uscd �s a ...y���.t-� ...... �.r�_ _.. ,•,.,� _ . <br /> i � ' <br /> '1'h�• cu�ncr o[thc Premisrs is. _....._.. .. n -- �_ _. �'�:".. <br /> �fr�.Y >lz. > <br /> 'I'I�.r nFent is_...._......................._.._ ._...__.._........._....._........___�..Q..or�.r .�.>,.; <br /> e'F - <br /> 'i'h�. :ipp!i�z;ition, althaut�h si�ned, �ha11 nu Ue binding upo hc City, until <br /> :�c<�cntr�l b�� �hc Supe intcndcnl of �hq Waler �epartment. <br /> � � . <br /> -�� . ... � ,._ � �.ev.�-.�� <br /> / <br /> .,.i yned.....�.�`:.�:�..._�.��.....�._.........r.�................__. .... ..__...._.ApPlican t <br /> 1 <br /> \ ;�, .r��.�. 1P. . 14r. . ..._. . _ .. ... <br /> ' SuPori V rud��u;. <br />