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; - ': � /c��/ <br />W. D. fo�m 4 <br />CITY OF EVERETT-WATER DFPP,RTMEP:i <br />APPLICATION FOR W�.TER <br />All blanks mutt he tilled in or crossed out _� <br />�, , L-�� <br />-- �_-.>...1._........ _ ....�9_.._.. <br />Ev�r�u,...._.._......�...._�..... _...... <br />TO THE SUPERINTENDENCITY OF EVERETTDEPARTMRNT: <br />I hereby apP�Y for the use of wnter in accordance with the rules and re6u- <br />lations of the \Vetcr Depariment, for purposes and fixWres stated Uelow. <br />During thc limc that any o[ thc walcr mams ma}• bc taken up by rcason <br />ot any improvcmcnts authoriud by thc City ot Eve:cll, in or ot any slrect or <br />allcy in v:hich they may have been laid, the Cily �e.�l not bc required to [urnish <br />ply�r�ayutl us Uc cu�t o[tsorbc 1'� blePor�a }Cdamages ior itsUfa lu c�so lo do. <br />�J / � i <br />Application No. ...�/...�57 ................ ��n , ' . . <br />' , . � , . ,�.�J <br />// .....__._ Add .......:.....__..__��_.._.... . <br />lllock.._....T.._.... . Lot.._..........._.......... <br />. <br />� , - <br />- —' ^ ' / .' � '• ../��....�t�:.e..�........_......__.Slre t <br />No._ �:.-'�....... n_ ..... ......� ' ................ ........ <br />...__.. ....._......_.___. <br />�Phe work to be executed by.._............_ ................ <br />....... _.._ .................... _..Plumh_ r <br />Slatc izc of tap. i g <br />�/�._Tap to be inserled in thc main. �� ,� �' Gi� ��'-�R—'� " <br />l � '� <br />.J...�....Nalcr dosel <br />. "LBath �� n��i _ uJ <br />J�. .. ` { :' <br />. .....Urinal � <br />��/� . . ._, �c t ; Everet� <br />_.___......Plain f�ucel insidc � , <br />._...........Sidc walk tvasiicr � �'.'�r'(cR DEP_T.� ��. <br />....._....liosc Uih oulside /...� " <br />. ....__..._Hose bib for buiiding pw'poses ^ �-,1� � , <br />_ . i <br />.........._.._Iiose bib inside <br />.....13ib for stablc cor�lainin�_._......___...slall_ . . _...... <br />...__�....._Numbcr of persons in tamily <br />.��-.. Numbcr of rooms in Uuilding <br />TLe premises are to be used as a .......__.. ..-. -.. . -.. <br />�.�: �. ,. <br />'Che owncr of the premises i:; _..,._ ._ ...___.......� . ..__. ...�._. _ _. <br />Thc agent �s....._._.._ ._. __. ._....__._ <br />.._......... . .._ ' . . _._. __. <br />;�ecepted by�the Superintendent�n[ the�Water�Department.upon tl e City�, unh] <br />SiFned ........................... . . . ......_.......... _.........APPlicant <br />.... ... .. . . .... <br />�� C. . 5 ..,'.�..� .:i'... <br />AccePted._._. .__ ................ .....1.... Bv�l i ...._$upenetendent.-� <br />t % <br />