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'1 J <br />� ' .i <br />W. o. Fmm a <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />- <br />Evcrett�.........__.._._.._. �.�.... �... �.._ ..............._._.....1�J.�l.c/ <br />TO TIIE SUPF.RINTENDENT OF THE N'ATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply far the use of water in nccordanee with the rules and r^_gu- <br />lations of Ihe 1Vater Department, tor purposr.s and tislures slated Uclo� �. <br />During ihc time that any of thc watcr mains may Ue taken up Uy �•eason <br />oC any impravements authorizcd Uv the City of Everett, in or of anp street oc <br />allcy in which thcy may have Ucen�laid, the Cily will not be required to furnish <br />watcr during thc progress of such improvements to any mnsumcr w6ose sup- <br />ply may thus Uc cut off, or bc lia�lc f9r any damages for its failure so to do. <br />d�.� <br />Application No_�.. a_ ........................... , - <br />i' . J <br />Elock. ... �_ ._. Lot .__. �J__...... Add..�/.,�a�..�.r.G.lc..1/�r�'� <br />jl ��' . %...c<<........cr�!_�c�-9trcel <br />No . . . ... . .. .. . . ..`., <br />Thc rvork to be ex.ecuted Uy....._.......__....._....__ ._..__........._....._...._ P:umbcr <br />Slate sizc o[ tnp. <br />_..__........Tap to Ue insericd in the main. <br />..... f.......Natcr doset <br />L _. `,�.:....Bath <br />..._. �......_.Urinal <br />..._........._Ylain fnuczt insidc <br />���i��.. <br />. ��.� ��: <br />..__ _.......Sidc walk washcr . NC��4 l�U'64�� �� (- <br />. ..._.......Hasc bib oulsidc <br />...............Hosc UiU for Uuilding pmposes C�,.- �� �';:��etij 0. "c <br />__._.........Hosc Uib insidc Il'.11 _:i i::i=�7�. %� . 7; � <br />.� t. < ` <br />................IIiU for slablc containing................_...stall.................... > . ' � / <br />.._,.__N�mber o[ persnns in tamily <br />.'�._......_NumUcr of romns in Uuilding / <br />9'hc Premines arc lo bc used as a....._....�,.. .�:lr�.L�C.e.�.s.L..(c �.c <br />,, ,�- �r ,, � � - <br />Thc awner o[ the premises is__.._. � y" ,�. 1...�/,�.,:.r .. �<,( , ' <br />. -. _...,..,:. <br />Thcagent is....._...._ ...................................._.ia.c_.�......................_.............___..... <br />Tliis npplication, althou�h signed, shall not be Uinding upon the City, until <br />:�ccePled by the Superintendent of the R'ater DeparUnent. <br />S��asJ..�:� .....__......._ . __.___ ____.__.__...........Applicant <br />A�.crp;cd. _ .. _ . . .. 1�.___ 131'...._ . _.. ._...._.__.._._.. <br />Superintendent. <br />