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w. a Fo�m n <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />Ail blanks musl Uc filled in or crossed out <br />Evcrett�.._... ....yJ.....J.. � . _....19.G'.G� <br />. ..... _... _. ...... _. <br />TU TIIE SUPEIiIN7'ENDENT OF TIiE \VATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hcreby apply tar thc usc of watcr in acmrdancc wilh thc rules and regLL- <br />..:�'�ons at qie \9aler Department, for purposes and fixturrs siated below. <br />During lhe timc lhat any of lhc watcr mains may bc taken uP >>Y reason <br />nf any improvcmenls authorizcd by ihc Cily o! Evcrclt, in or o[ any strcet or <br />allcy in which thcy may have been IaiJ, the City will not 6c rc9uired to furnish <br />�r;drr during Lhe progress o[ such irnPravements Lo any consumer whose sup- <br />ply may lhus bc cut oft, or bc liablc fur :my damagcs for its tailure so to do. <br />Application No.._,l.�.r... jLr%�.^...... / /, C.r er, r�/� .�.. <br />IIlock ........ . .. ........... . ..... L/ot__. 5 . c� !�'. /..;.... Add. � � . �.. : /.. .; c i,� -. . <br />No..........._...........�.�.......� �.�/t4r.�:C..<!r /�L-......_Sltecl <br />_��.4....._......— . <br />....... _ ..........................................__..............................................._ _.... _... _.......... _ _.. .... . _.... _.. <br />The work to be executed by_.._._._...._........____......._......._........._ .__Plum�cr <br />Slate sizc o[ tap. <br />.;�� ...Ta to Uc inserled in ihc maia � <br />�.r:. n ' � - <br />I .-.. .<. ���'.✓�..� ,,� <br />_._....__. Natcr cluscl �- /, . .. <br />/� l IIath <br />"9--....,�;._ <br />.......... .. Urina] <br />.._......_..._Pluin faucct in�idc <br />...... Sidc wa7k �vashcr ... _ . �. ,' p <br />...__.........Iiuse 6ib outsidc , _ ��`� �� � <br />„ <br />..._._........Hose bib for building purposes .��'' y// <br />._. _.........Iiose bib inside ;;,.;r '-✓ �'�, y <br />._.._ .......I3ib for stable containinF ....................staill ._.._......�..... <br />�:ll <br />_._...Numbcr o[ persons in family <br />v_.._...Numbcr of romns in Uuilding -' j' <br />� <br />Thc Premises arc to bc used as a..........._._._..... ____ .___............_.....__....... ... <br />The owncr of the Premises is ......._. _..___ .........__... .__ .. _. <br />'T6c agcnt is._.... _............ ..._._ ...... . ........_. ......___._..._... .. <br />This application. �IthouFh siF��«j� �hall not'�c binding upun the City, until <br />:�cccpted Uy Uie Superintendent of the Water Department. <br />� . <br />. S't�d1l %•�.v .�.�.C. c_ � ii �.. �..-�::5.....__......._..Applicanl <br />.. _r... _ ................___..._........ <br />.\ � p;cr ..... _.. ._..._.1�....... 23y_ ... ._..__.. ... . .. <br />__.. Superinlu�dcnL.. <br />