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W. 0.FoTm < <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett ................................ <br />�...%.— ........... ....... 19. <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lations 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 <br />of any improvements authorized by the City of Everett, In or of any street or <br />alley in which they may have been laid, the City will not be required to furnish <br />water during the progress of such improvements to any consumer whose sup• <br />ply may thus be cut off, or be liable for any damages for its failure so to do. <br />i <br />Application No... _ .......... <br />Block........................................ Lot........................................ Add .......................... <br />No..................,T<...... �s:a�..�.�:er................................... ........... Street <br />The work to be executed by',. .... ....... .... .... ............. ....... Plumber <br />State size of tap. <br />...... Tap to be inserted in the main. <br />................Water closet pp n E <br />.............. ■ A 111 <br />................Urinal <br />................Plain faucet inside APR <br />................Side walk washer �tjBfE <br />................Hose bib outside <br />................Hose bib for building purposes ydATER Pam,-' �' <br />................Hose bib Inside <br />................Bib for stable containing ......... ........... stall ....... ............ <br />. <br />................Number of persons in family <br />................Number of rooms in building <br />The premises are to be used as a............................................................................... <br />The owner of the premises is........................................................................................ <br />Theagent is................................................................................................................... <br />This application, although signed, shall not be binding upon the City, until <br />accepted by the Superinnttendent of the Water Department. <br />Signed.M...2`4.!........J'd..rt..Lpplicant <br />Accepted............................................19....... By..................................................................... <br />Superintendent. <br />