Laserfiche WebLink
- �<- ) <br />� [ <br />V!, D. Faim 4 /' � <br />CITY OF EVERETT-WATER DEPARiF'ENT <br />A.PPLICATICI�I�T F(��2 WAT�R <br />All hlanks must be filled in or crossed out <br />-ti-; �', � � 7'•l <br />,_ � _ � � — /:.c!....:.....�::.-f.._.......__._.......is.-��..`/ <br />Evc rc,c ................... _. <br />TO TI-IE SUPERINTENDF.NCIOY OF EVERe,TT_ DEPARTMENT: <br />I hereby applY for the use of water in accordance with lhe rules and reEu- <br />]ations of the Water Department, for �urposes and fixtures stated below. <br />During the timc that any nf the water mains may be laken up by reason <br />of any improvements authorized by thc City of Everelt, m or of any street or <br />;.Ilcy in �ahich they may have becn laid, the Cily'•vill not bc required to furnish <br />il�tma uttms bc ut offsorbeUliablc for anyedamages�tor it;uf+lurc'so�to do. <br />[ Y Y <br />P.,ppliration No...._��.f:.'=��. y....... <br />. ... Add._ ........__._.._. _._. <br />Block..._..--......_ .............._.... o . ........_.. / <br />....__....__...... . . _ _...... <br />� r...... lJl_-.!f-.�,�j.l,,4.._ .................StrceL <br />No....._ .................�.�..J�_0....�.- ✓ <br />...................................................... ............................................................. <br />The wnrk to be executed by._........_...__.........._.._...... <br />._...._ __.......Plumbcr <br />Statc size of tap. <br />.�j.��....Tap to be inserted in thc mairi. <br />__.......Nnlcr doset � � �'� -�%` <br />�!.......Bath r �' j� � <br />......_........Urinal / . �ct � <br />..__.........Plain faucet inside <br />� S t � �: <br />........_...._Sidc walk washer <br />_._...........I�Iose bib outsidc <br />_._....__...Hose bib for building Purposes <br />................Hosc bib inside <br />..._...........Bib for s!sLie contammg ............... ._st�ll_....... _ . _ .. <br />_._....NumUer of Persons in family � �''� ��" <br />. J..�_.....Numbcr of rooms in building z�> o/. :�; r ' <br />✓ � /1. /:_ ,. <br />- .. .. � . _... <br />'Che Pcemisc� ure to Ue used as a .............................................._ ._ .__. .. <br />'Phc owner of tl�c Premises is.._.._....._...._ ......_._...___..._.......... <br />......._........._......_._. <br />7'he aSent is...._ ........................_...........__...._........__.. <br />_ _._...... _......... _ .............. _ _........ <br />Th�s application, although signed, shall Dot bc binding npon the City, until <br />acce�rie9 by the uperintende t oLthe �r Depnetment <br />S�.nc:7.�SL^.-rj����•-l�_�` _../......._�pplic:,nl <br />. _._.1�.._... Rc __...". _ .__.. .... . __....... <br />A��r,>u�, _ __ .... . �.:_ _ ... SuPe� �ntenden�. <br />