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W. D. Form / 1500 0-1-170. P. <br />CITY OF EVERETT­Water Department <br />Application for Water <br />All blanks mufOREVERETT: <br />r cro/sset //,, // <br />Everctt... 0 <br />-- _----------—19Y..7- <br />TO THE SIJPERINTENDEN'1 O DEPARTMENT, <br />C <br />I hereby apply for the use of water in accordance with the rules :md regula- <br />' lions of The Water Departm-nt, for purposes and fixtures stated below. <br />During the time that any of the water mnins may be taken up by reason of <br />any improvements anthorized by the Citv of Everett, in or of any street or alley in <br />which they may have been laid, the City will not be required to furnish water during <br />the progress of such improvements to any consumer whose supply nmv thus be cut <br />off, or be liable for an7 dami}:es for its failure so to do. <br />.. <br />Application No.___ ---- <br />Block Lo Add _.__.___.___.______ <br />The work to be executed by -------------- __ _----------------------- Plumber <br />$mlC/;?:COT tat.�O�_ i /t <br />� [--%J Tap to be inserted in the main. --y]fx� [/l/�U/'r/y <br />---------- Water closet <br />---------- Bath <br />.--- .Urinal <br />----__._..Plain faucet inside <br />---------- Side walk washer <br />---------- Hose bib outside <br />--_-__ -_}lose bib for building Purposes l <br />---------- Hose bib inside <br />---____-__Bib for stable containing ------stall---------- <br />Number of persons in family <br />_Number of rooms in building <br />The premises arc to be used as a ......... ............... <br />------ <br />The owner of the premises is -------------- ____---------- __________________ <br />The agent is .___----- _____------- __________________________ <br />This application, although signed, shall not be binding upon the City, until ac. <br />cepled by The Superintendent of toile Water Department. <br />J Signed �:1_ '1'?�'-�__T__. /_.___.__ .. Applicant <br />Accepted <br />