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W. D. Form 1 I500 J-I-17 C. P. <br />CITY OF EVERETT�=Water Department <br />Application for Water <br />AII blanks must be fi�led in or crossed out <br />Evere[[.-_ '____"'_____'___'.� �_f_"'__._191��' <br />TO THE SUPERINTENDENT OF 1'HE WATER DEPANTMENT, <br />CCPY OF FYERETT: <br />I i�ereby apply for the use of w�tcr in accordance with the rules and regula- <br />tinns of The Water Departm:nQ fur purposes and fixmres stated below. <br />During the time that any of the watcr mains may be taken up by reason of <br />any improvements authorized by the City of Everett, in ur ot any street or alley in <br />which they may have bem Iaid, the City will not be required to fumish water during <br />the progress of such improvemen[s to any consumer whose supply may [hus be cut <br />nN, or be liable for any damaqes for its (ailure so to du. <br />ApplicetionNo.'--�!2-Q-Z-'-" �� � Q^� � � ' <br />Blo �—..�_"_-_—_}_'�__:�' '_ Lo["__'_"_'_____.___..Add^�'_-^_-"__^.+=^t__'_ <br />Na���l._p-_-LO OI__-f-.!�`�..Strect <br />_"_"_-_.._'_."_C_C..'"___ �('. p-_-_�'___e"--� "'_"'. <br />'Che work to be execu[ed Uy��-'____________ ____ ____________._ Plumber <br />Sta[e size u( tap. <br />��____Tap to be inserted in the main. ���^� O <br />..____.___Wa[er close[ <br />---' --- _ IIatt. � <br />_..._._ .Urinal <br />_________Plain faucet inside <br />__.______Side walk washer <br />_ _ _ _ _ _ _ .. _Hose bib outsiJe <br />..________Hose bib forbuildiry! purpnses <br />__._______Hose bi6 inside <br />_________Bib for stable containing.___ __.._ __stail___ ______ <br />_ _ _ _ . _ _. _. Number of persons in (amily <br />________Number of raoms in building <br />Thepremisesaretobeusedasa_______________________________ ____. <br />The owner ot [he premises is ________________ _ <br />_____________'______'_'_____'__ <br />Thcagentis. _"'__'_...____-'_"_____' '___" <br />'_-__' "_.________'__. <br />This application, allhaugh signcd, shall not be bindinq upon Ihc City, un[il ao <br />cepted by The Juperimenden[ o�he Wuter Department. <br />� i . <br />Siqned ____"�"-" - : � . � � ' <br />"--'---''------ �----- -""'--'ApPlicant <br />Accepled______________'______191 BY___'__.__"'___"._"__'______ <br />L . � / ,� Soperinl_ndenl <br />! �C �l./) �_ <br />