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in.¢ ' <br />W. D. Form 4 I500 d-1-17 C. 7. <br />CITY OF EVERETT==Water Depariment <br />Application �or Water <br />All blanks must be filled in or cross,�ed out <br />Everett�..---'-------'----..""�-9---' --.791�..p- <br />'CO THE SUPERINTSNUEN'P OF THE WA'CCR DEYARTMENT, <br />Ci7'Y OF E`lERETT: <br />I herehy apply fnr the use of water in acco:dance with [he rules and regula- <br />ti�,nu o['Phe �Ya[er Department, fnr purposes =md fiztw'es stated below. <br />During the time that aup uf the �vater mains may be taken up by reason o[ <br />any impruvements authorized b}' the City of Evere[t, in or of any strcet or alley in <br />which they may have been laid, the City wili not be required to lumish water during <br />[he progress of such improvements to any consumer whose supply may thus 6e cut <br />oH, or be liable for any damages tur i[s failurc so [o do. <br />APPlication No.'-- � Z.•2'- �"--- � �-y�—� � <br />Block.--"---'--' --'.__Ln['-----'----------'-Adr_>ZaA,x.�c�=L..—' <br />No.�-- //.2. �__�'_�_�...Street � . <br />-- — ------ -- <br />-' . <br />----�,----- ��� -' �-- � -- �` -�---> ,_ � <br />-- - — ----- <br />.......... ..... - - <br />'fhe work to be exewted b._____.---_____..-----___ ____------ Plumber <br />S[a[e size o( tap. <br />__.__Tap to be ins•erted in the main. <br />____.____Water closet <br />-"'--_'. Bath <br />________ .Urinal <br />____._.__-Plain (aucetinsidc <br />._________Side walk washer <br />. _ _ _ _. _ . _ _ Hose bib outside <br />__.____---Hose bib forbuilding purpuscs <br />___..____--Hose bib inside � <br />._'_"__._6iStors[a6lecnn[aining ____'--'---s[all_'______' <br />____._.__.Numher o( persons in family <br />_________Number ot ro��ms in buildinK <br />The premises are tn 6e used as a__--------.------- ��------------- -----� <br />The owner of Ihe Premises is "_'--�---'---' ------------'----'—'— <br />TheaRenlis __."____"_"._._____.____"'__..._________ <br />This applic�[ion, although signed, shall no[ be hinding upnn tlie City, un[il ao- <br />cqep�ted Uy The Superintenden[ �o('f`j c Neter Department. <br />_ 0 ".7'�-P S ned _ � �_c�- / ��c s--=-' ^..-`-�.`-- �-'-"----'-APPlicant <br />a i---�-"�-�'-"-=f- <br />AccePeea--------'--------1s1 KY----------------- -- <br />'_-.snr.:intendem <br />� . : ,a' �/. -, - c' <br />