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W. 0. Form a <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATIOT�T FOR WATER <br />pll blanks musl be filled in or crossed out <br />,� ' � J �� - <br />Evcrclt,..... � � � f _.__._.. __19.. _... <br />_._...__ .._......... <br />TO TItE FUI`tiRINTENDENCiOY OF EV RETTDEF.'�RTh7ENT: <br />I hereby apply for the use of water in accardnnce wilh the rules and regu- <br />lations of the Naicr Deparlmenl, for purposes and fixtures slated Uclow. <br />During the time that any o[ thc watcr mams may bc t�iken up bY rr:.son <br />n( any imProvements aulhorized by thc City pf Everett, in or of any strecl or <br />allcy in which they may have Ucen laid, the C�ly wil� nol be required tn furnish <br />ply m yulhus be curt o[tsor be ]iable porVany damages for itsufa'lurelsos to do. <br />�z i� ' � <br />Applicalion No. � �� �- f � � � � . <br />���. . Lot./ �:.._ .:..�...... Add,�.l � �.... ::..:-.. ,v <br />IIlack.._,._ � , � � ' - ,. <br />^— - <br />i i,.. <br />— - ^ if , . .. . � � . .._ - .... Slreel <br />-- .✓.r. ...........__..:_.......... <br />No.... ....,._......_ ............ ._-- <br />......�..-.... <br />� . � � . .............. <br />The work to be executed by_..._.__._... __......... <br />.........._...___.... ._ _.....PbamUcr <br />Slate size o[ tnp. .-, <br />��'..��..__Tap lo Uc ir.scrtrd in thc maia � �` � <br />�;. !�/�,! <br />......_..._...Watcr dosct ' ,. , � / ' �� . <br />................IIath � _� �- �..� � _ . <br />/J �� � / <br />................Urina] '- <br />.._........... Plain faucel insidc �G . �. � ,•� <br />.....Sidc walk washer ��� �'- - � <br />.......... /r/ , ,. . . <br />....liose bib outsidc � <br />13osc bib for building pw�poses ��?.''� .� .. <br />................Ilosc biU inside Jr�r��, . . <br />._....Bib tor stablc containing..._.__..._...stall .................... - <br />._.__. •..,..- , <br />....,�... �� YI' <br />_.,_..... .... Numbcr ot persens in tamily �� � <br />.._._....._ NumUcr ot rooms in bvilding �� <br />� � ' . — � � <br />...,._ ..............�!_.:.'.:..;•:.......___... <br />The premises arc lo be used as a........:../___..... <br />. _....._. _ .__....___.. <br />Thc owncr of thc premiscs is._...__.._.. .....--.- ... <br />__._..._._ _. ...._.... . ___._..... <br />Thc aSent is_ _.... _......_.. . . <br />This application �Ilhnugh s�Fned, shall not �e bindmg upon the City, until <br />nrrrptcd by the Superintendqntpf thc Water epae.�nent , <br />SiFned.._t�•r�-�LiC..t�t�J........�. .se :.�:!'""�...._....ApPlicant <br />,.7 %�- � <br />Aeri�p:c;] . .. . 1^. ... I3}'... ' Supci mhmiiunt ...... <br />