Laserfiche WebLink
_ _ - .�'� <br /> , <br /> W. �. F�,m : <br /> CITY OF EYERETT-WATER DEPARTMENT <br /> ���PILICATI�N FOR �JATEIZ <br /> All blanks must be filled in or crossed out <br /> ��,. .r�i:........................ .....19 1�....�. . <br /> Isvcrett,.........._........__. ._.... <br /> TO TIIE SUPLRIN"fP;IQDENT OF T4IE WATER DEPARTMENT: <br /> CITY OF EVERETT: <br /> I hereby apply for the use of water in accordance with the rules ,�nd regu- <br /> ]�tions of the Waler Department, for purposes and fi::tures stated beiow. . <br /> During the timc that any of thc water mains may bc taken uP b7 reason <br /> oC any improvemcnts authurized by thc Cily of Everett, :n or of any strcet or � <br /> allcy in whicL thcy may have becn laid, the City will not be reyuired to furnish <br /> water during the progress of such improvements to any consumer �:hose sup- <br /> ply may thus bc cut off, or be liable for any damages for its failu:e so to do. � <br /> /`` � <br /> Application No{.........�1.;�::............ <br /> Block...._.................................. Lot.......__._._....._................ Add.__..................._................ � <br /> h ;? <br /> No....__�.::._Ul-_�2_�:i..........._......................................................Strect <br /> _ _ _................_..............._....................................._................................................................ <br /> The ��•ork to Ue executed by........__.._.............__.......................__...........Plumber <br /> Statc size of tap. <br /> �� „ <br /> r_._........Tap to Ue inscrted in thc main. <br /> ._.............Water dosct <br /> .._._.........Bath <br /> ......_.......Urinal <br /> .. _._........Plain faucet insidc "`� � . <br /> . ._........:_Side w:ilk washcr "�'� -�:� <br /> ..._...........I�Iose bib outside �( � ° � <br /> .__._........Hosc bib for building pur oses � u <br /> P �,= �. <br /> .___......._Flosc bib inside � �' <br /> .._........Bib for slable containin . ._..._...._...., I '� <br /> .. . g... `�ill............r._._. <br /> .___.........Numbcr of persons in family <br /> ..._.._.......Num6cr of rooms in Uuil:ling <br /> l'im premises are to bc used as a........_......__.................._..._._.___.... .._.._. _..... <br /> 1'hc owner of the premises is...___.__._._. ._........__._....._._.__...._..._.....__.._........ <br /> '1'hc agenl is....................................___.___.......__..............._._ ..__..__......__........._. <br /> 'l'hi, ap�lication, althnu„^h siFned, shali not be binding upon the City, unti] <br /> .iccepted by die SuPeria �nden of tpe�'ater D���ent. <br /> / � <br /> SiSne (?si.... ..` . J . . �... !a+ . ' PPlicant <br /> � �.._.. �7r � <br /> A�•c��plc� .__. .. . . . . ._....1R.__.. BS .__ ...__�... <br /> . . _. . . ....... � <br /> Superintondent. <br /> .��Il�i� �'L7� <br />