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W. D. Foim 4 <br />CITY OF f <br />ETT-WATER DEPARTMENT <br />APPLIC�'� ION FOR 9�JATER <br />All blanks must be filled in or crossed out <br />-- 7 _ i. / / <br />Everett..................................... /........... �'..........._.......19 v F <br />TU THE SUPERIR'TENDENT OF TFIE WATER DEP.�RTMENT• <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />laticns e[ the �Vater Department, for pmposes and fixlures stated below. <br />Dur'ng Uu timc that any of thc water mains may be taken up by reason <br />oF any improvcments authorizcd by tl�e City of Everett, in or of any sireet or <br />alley in which lhey may have bcen laid, thc City �aill n�t he required to furni=h <br />a�aler during the progress of such imProvemen[s to �ny censumer whose sup- <br />ply may thus be cut o[F, ar be liable for any damages for its tailure so to do. <br />/ G� � %) - _ �,- <br />ApplicationNo._....l..(�../...�f....Y. .`/y":..r-tc-c..��o ��1J��1-[. <br />7 <br />Block............._...................._... Lot..........r�. .—...__............ Add.......__.......��..:..�-..... <br />!% ) � �� - I/_.7/— C" �.[� ...........Street <br />No...................... ..... ............. .. _ .... _.... ....: �. z ...................... <br />The work to Le executed by.. ..._..........._. <br />,State size ot tap. <br />�_ i. <br />Tap to be ins�rted in thc main. <br />� . Natcr closet <br />..`........Bath <br />�...� <br />................ Jrinal <br />................Plain iaucrt insidc <br />_._..__.....Side walk washer <br />...............Hose bib outside <br />__..._.......Hosc hib for building purposes <br />._.........._f�iosc bib ir.side <br />.............._..................... _.....__..... _....._. <br />...___......_._. _.._..._._ ......_..PlmnUer <br />� S �� < < <br />"� {3 � )c� <br />� pJ � "'JLs�-L <br />�� A j'u� �, <br />�lE 10'64 � : �,� <br />r�r�; of Everett�cat )io <br />,,�,�R DEPT. A� ; YJ � <br />_..._._......Bib fm• s".ablc containing.........._........stall...._..._...._... <br />._..._.......Number of persons in familp <br />_��......Number of rooms in Uuilding , <br />The premises are to Ue used as a.......__.._.........___.._ _._...... .__...... ._..._ _..... <br />Thc o�vncr of lhe Premises is ..................____.._...............__..........__......__.....__..... <br />TheaBent is ...................._...._....__............___.......__.__............_......._.........__........... <br />This application, althout;h signed`, �hal] not 6c�ndi�pon th�City, until <br />accented by Uie SuperinLendetri, o�lie W� j ep� tmmt. �� � L...... <br />Signed..���_�..:1:::'...:.. ApplicAnt <br />Acccpteti.. . _ .. _.. .... �...]B.._... By. ......__._ . ... ..... .... _........... <br />Superinti ndcnt. <br />