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. � �_:�-�:: •x�+:s; ... . <br /> � <br /> � <br /> �i <br /> i� � <br /> � <br /> H'.D. Porm 4 �.� � <br /> CITY OF EVERETT-WATER DEPARl � "ENT � <br /> APPLICATION FOR W,AT�R <br /> All blanks must 6e :illed in or crossed out <br /> — I <br /> �vcrclt........................._......_�S t.r.�..:2�.... ......__.191.� <br /> TO THE SUPERINTEnDENT OF Tf1E V.'ATE DEPARTMEPIT: <br /> CITP OP EVERETT: ' <br /> I hcreby apply for lhe use of water in accordancc with�the rules and regu- <br /> lations of the Water 7epartment, for purpnses and tixtures stated 6elow. � <br /> During the time that any of thc watc: mains may bc taken uP �Y i•easen <br /> of any improvemenis authorized by the City of Everett, in or of any strcet or � <br /> allcy in which they may have oecn laid, the City will not be required to furnish <br /> watar d�ring the progress of such improvements to any consumer ���hose sup- <br /> ply may thus be cut oft, or be liaUle for any damages for its Failur.: so to do. , <br /> APPlicationNo......../_��.�o' � `-'`;'/i .�{ n✓. .� I <br /> ....................... . ...._.....l. 9dd..._...........................__....... <br /> Block........._............................. Lot....._............... c U� - C'�� J <br /> No...`:'.'.._`.7 . '_ . . <br /> '` .� �' x �`"a"' . ........Sfrcet <br /> � ....._..._..._.......................... .�..�'...._...................... <br /> The tvork to Uc esecuted by......................._._ . . ... . ._. _.._. .... .___ .. PlumUcr <br /> Sta.e sizc of tap. � <br /> ...G...� Tap t� be iuscrted in Lhe maia s,��. II <br /> , � ., <br /> ._...._.......�Vatcr closet �'` ' <br /> ..._ _........Bath `�. . ;; i .,- ,�.=. <br /> ..............Urinal Y» ,�j �i <br /> 9pt� E ,_ �. <br /> ...._..........Plain faucel insidc �- . f;-t - .. � �- <br /> .___........ <br /> Si3e walk tvasher ���Or E,, �c" i ��; '� <br /> � Br:.:i: � � I <br /> .. ... ........I-Iose bib outside '��� �y ' <br /> . . . .... � .. <br /> .___.........Hose Uib for building purposes �r` $%� :- <br /> ................F�Iose bib inside <br /> ............._.Rib tor staUle cont�i.._..,:...._............s�all_. ......_........ <br /> .. _...........Numbcr of pecsnr.s in famiiy <br /> ....._........Numhc:of :ooms in huilding <br /> The Premises are to bc used as a........_........__.__..........__...____ ._._. . ... _ _._.. <br /> The uwncr o: the pren��is�s is. .........._.._ ....._... .... ..__._._ ._..._. . <br /> q�s,, agent is.__..._.___.._........._.. .___._.__................_..._.......___._. .. . .... <br /> . _._..... ..__........ <br /> T��'s ��PP�ication, although signed, =ha11 not be binding upon the City, until <br /> arcep[cG '�y thr. Super�ntc .Icnt of the �4'ater Depariment. // <br /> �, ` {�� (�/ i <br /> SiFnc .. .....fz�(2��L.,f_?/..�L..��.d ..��-��..Applicant <br /> � J <br /> n-����c��,.... ... ... _. . ..... . .....is. _ &Y. ... . ._..... <br /> _ ........__... <br /> Sunerintendent. <br /> I <br /> V <br /> i <br /> ,_._�.._..-.._. . ._ <br />