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r_H-7j 6—�9—ZL q1 <br />W. D. Form s t500 3-1-17 C. P. ' <br />CITY OF EVERETT—Water Department <br />Application for Water <br />All blznks must be filled in or crossed out <br />TO THE SUPERINTENDENT OP THE \VAT •R DEPARTMIEN <br />CITY OF EVERETT: <br />1 hereby apply for the use of water in accordance with the rules and regula. <br />tions of The Water Department, for purposes and fixtures stated below. <br />During the time that any of the water mains may be taken up by reason of <br />any improvements authorized by the Citv of Everett, in or of any street or alley, in <br />which they may have been laid, the City will not at, required to furnish water during <br />the progress of such improvements to any consumer whose supply may thus be cut <br />off, or be liable for any dammrages fo its failure so to do. <br />Application No.__ 7 J,_ ..... <br />No.___c%..�_�.-O....... Street <br />------------ <br />The work to be executed by_.___.. <br />State size of tap. <br />-_13//_.Tap to be inserted in the main. <br />—___ Water closet <br />---- I____.Bath <br />------- .Urinal <br />-------- .-Plain faucet inside-' <br />----_---- <br />Side walk washer ' <br />. _ Hose bib outside <br />- - -. _ _ -. Hose bib for building purposes <br />--------- Hose bib inside <br />_______Bib for stable containing. .......... staff ---------- <br />---------- Number of persons in family <br />-_- Number of rooms in building <br />The premises are to be used as a-------------- <br />Tbc owner of the premises is <br />The agent is.. ___. _____, .-- <br />This application, although signed, shall not be binding upon the City, until ac. <br />cepted by The Superintendent of the Nate Department. <br />-_--,Applicant <br />Accepted__�__��___197` B> <br />Superino dent <br />