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W. a Fb,m a <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled In or crossed out <br />IEverett,._ .... ................... L.i,e LS.(.. ................. III. `..:.j <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water In accordance with the rules and regu- <br />lations of the Water Department, for purposes and fixtures stated below. <br />Durinf the time that any of the water mains may be ,iken up by reason <br />of any improvements authorized by the City of Everett, In or of any street or <br />alley in which they may have been laid, the City will not be required to furnish <br />water during the progress of such improvements to any consumer whose sup- <br />ply may thus be cut off, or be liable for any damages for its failure so to do. <br />' APPlicatlonNo%..�'......... <br />Hlock.......lttt.. Lot......__._--'.....__......... Add,.%._�.re..,.�.-.=..,C <br />.................... .. . <br />Y <br />No ..... .�`_.�N.f[-!{.....,.1:........................... .......'Y:............_......_.._.Street <br />..................................................................................................................................................... <br />The work to be executed by ... ............. ...... ....___......__............. ............ ..Plumber <br />Slate size of tap. <br />........Tap to be Inserted in the main. <br />.. ,...Water closet <br />..r.� .�.:. -..Bath <br />................Urinal A ; <br />................Plain faucet Inside <br />................Side walk washer <br />�F <br />._ .............Hose bib outside <br />................Hose bib for building purposes <br />................Hose bib Inside <br />................ Bib for stable containing ....... ............ stall..._...__..... <br />....... ..//.._...Number of persona In family <br />............Number of rooms In building <br />The premises are to be used as a_ .... <br />The owner of the premises is. _.. _. <br />The agent is ............................... _. .__.. _ .... <br />This application, although signed, shall not be binding upon the City, until <br />accepted by the Superintendent of the �Water Departrrtep�t/. <br />Slgncd........../j.t..1�..:'.�_4...`..R..:�6%�,1_:f,.��:�4%:../Applicant <br />Accepted..........................._..........18..._.. By. _•...... _...._.. <br />Superintendent. <br />