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� R'.D. Fcrm 5 I500 J-0-17 C.P. ' ' <br /> CITY OF EVERETT-=Water Department <br /> � <br /> Application for Water <br /> pll blanks must bc filled in or crossed nut " <br /> � ! __ ._191 .�=9 � <br /> Everett. -----"�---� ' <br /> TO THE SUPERIN7'ENDF.N1'OF T11E WA:ER DEPARTMENT, <br /> l'ITY OF EVERETT: _ ,, <br /> 1 hereby applY �nr the use of water in acrnrdana with the rules.�nd regula• <br /> tinns o(The Waler Deparlm.�nt, (or purpoacs and fixWres stated below. <br /> UurinK the timc that any of ihe waler mains mny Ae 'aken up by *eawn o( <br /> any improvementx authorized by the City o( E�erett,in or of nny sircM ��r alley in <br /> which they inay have been laid, the Cily will not be required to lu�nis�w;hus bercnK <br /> the progress of euch improvements to:+ny cnnsumer whose supply <br /> o(f,or be liable fnr any d.:makcs for its failure so ln do. <br /> ? ' 8 `1 <br /> Appli[n[ian Nn."" '1"— —{'--" ' <br /> _ __'___Adi .'�'___ ' <br /> [iluc '-"_"'�-' o <br /> _.- .in�L_____._' - <br /> No.------�— Ro S +_ I_9.__.s�ree� <br /> _ -_"_ . "___ <br /> _�.. �.•__�_. _. '_'_"__'"'"'" <br /> ___"_ <br /> " '_'__ <br /> _ '_ " <br /> � ._____.-.._._ Plnmbcr <br /> ��'�The work to be executed by---------'----------- <br /> Statc size o(tap. � l� � p <br /> � .._Tap ro be incerted in the main. <br /> -��_____W ater cloul � <br /> '__'_'___Bath ' <br /> '__ ___ .Urinal <br /> ..___'___Ylain faucet ineidc - <br /> ______Side walk wa5hcr <br /> __.__�{�se bib outside <br /> __.___.___Hose bib for buildinN PurPoses <br /> __.___..__Hosc bib inEide <br /> "___Di6 for slablc con'aining___-------stall_. .. ._... <br /> _,_.._____Number uf pereuns in familp <br /> __.'____..Nambcr of ranms in��iilAing <br /> Theprcmi_esarerobcuse asa__.--_____._--.--� <br /> ._.___.____ __.._. <br /> Thc nwncr ot Ihc Vremisc�is ____.. ------- <br /> __.._ _ _.-____ <br /> Thca6entis___"____ _ . _'.'_"_-_'__ '. ..__._ _._" <br /> _-.__.____-___ <br /> This applicatiun,although signcd,shail nol bc binding up��� the Cily, until ac <br /> mpled hy The Superintend�t�f ihc Nater Uep:atment. <br /> Signed_:�_.:�.�___'.___'._____�.._.___.__ :�'.'_'_'_'ApPlicant <br /> ' y .__.___..______'_.__"'_'____. <br /> elecepled--"---""""'--19. li __" Supe�lmendem <br /> i,i � �n < <br /> !:`_. <br />