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w. a F��m a ' .' / <br />CITY C� EVERETT-WATER DEPARTMENT <br />APPLICATION FO� WATER <br />Nl b�anks must be tilled in or crossed oul <br />—� <br />�. ..� J�1 � �� - � � <br />Everett,.._.....__..._ �-.=: ...._.._.l_........1 ..................___....19.. .._. <br />TO THE SUPERINTliNDENT OF TI3E R'ATER DEPARTIlIENT: <br />CITY OF EVER�TT: <br />I iiereby appll' for the use o[ water in acwrdnnce with llie rules and regu- <br />]atians o: thc \Valer Department, for pwposes and fixtures stated Uelow. <br />During lhc limc lhat ant• of thc water mains may bc taken up Uy reason <br />oC any improvements authoriud bY Lhe City o[ Evernit, in or of any Rtrcet or <br />alley in which they may have been I:iid, the City will not be requircd to furnish <br />�caler during the pn�;ress of sucU improvemenis to any consumcr whose sup- <br />plp may [hus bc cut u[t, or Ue liablc tor :my damagr,s for its failure so to do. <br />.'_ ' <br />ApplicationNo...��'�` � '' , <br />. ...... _ .................:... _..... <br />.%, �' �� '- - . <br />IIlock........_.r .... ................__ Lot...... �_.1.%'.�..-'............. Ad ..._._.. '"i , <br />. . .. _ _..._ ............... �.. <br />/9"'% �y� <br />xo.....____.. ._... ._ r ...:.............. .. �.:,C..-;.....1 .&i.._................._..........._..s�r��e <br />'Phc work to Ue executed bY........_._.._.........._____...._...._.........__.._._.Plumbcr <br />Statc size ot lap. <br />.- .!!��_Tap lo be inscrled in the maia . <br />. . �-n . . <br />_...__.._..Nalcr closet �/ ;. .—" <br />�� <br />. /_,..�...BatB , <br />-. � � �7 f.� . <br />.__...........Urinal � , � - }- ...y <br />. _... .......Plain fauccl inside (� � � " <br />� �i : i l � ' �' <br />_.. ._._....Sidc walk washcr �� ���� <br />. __.._ _.Ii�sc bi6 outsidc <br />. . _.__....Husc 6ib for building purposes � / <br />� � <br />.. . _........Iiosc bib insidc ' -- <br />. _ _.......Bib [or stable containing......._..___._stall..___.__. _. <br />. ..'4umUcr oF persons in tamily <br />r <br />.. Nwnbcr oi �ooms in buildmg <br />'1'iy��emises are to Uc used �s � �.�.___ ... ...... .'. _. . .. . <br />� � ` <br />'I'hc owner o[ the or�m�ses is.. ._�__ �� ' <br />Thc agent is___ ._. .__._._ .. <br />. . .... . .._ ____.. <br />9'hs application, nithnn�h signed, �hall not be binding upon the City, until <br />ac��rptcd by thc SuperinicndeTt of thc Natcr DeparLment. <br />i <br />SiFned_. ..�G`=�_:�........ . �` •'.:�. Applicar.t <br />d.; .. . , �� <br />A.,.cr,ptciL .. _.. . _ .__._I^ By� 1 .... � / . ... .. <br />_ . f . ... . _......... <br />V}>crinlrndi�t. <br />