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leiej yl <br />CITY OF EVERETT—WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled In or crossed out <br />Everett ......... ....................y <br />19 G `/ <br />TO THE SUPERINTENDENT OF THE *Fet DEPARTMENT: <br />CITY OF EVERETT: <br />I hereby apply for the use of water in accordance with the rules and regu- <br />lalionn of the Water Department, for purposes and fixtures stated below. <br />During the time that any of the water mains may be taken 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 />Application NoK.'...... <br />Block................ ....................... Lot � __. ......... _...... Add:n ._ �2.ts.z:.c........ .....` <br />No.........u?.-.%j...�.......l:zv.............................................Blreel <br />The work to be executed by .. ............. <br />.......__.............. _. <br />.... ...... Plumber <br />Sla,,A/ee size of tap. <br />...:T`,i/......Top to be Inserted In the main. <br />eC <br />...... ....Water closet <br />A � - <br />.../... J.Bath <br />................Urinal <br />41 <br />yJ <br />...............Plain faucet Inside <br />� ev <br />Side walk wash:[�`F,-� <br />bib oulaide <br />3 <br />_........ ..... .Hose <br />............... Hose bib for building purposes <br />a✓ y,�' <br />................Hose bib inside <br />...............Bib for stable containing...._ _ <br />._stall .......... <br />.........__.,.Number of persons in family <br />._ .... Number of rooms In building <br />The premises are to be used as n._. <br />The owner of the premises is <br />The agent Is............ _._._._.. <br />This application, although signed, shall tint <br />be binding upon <br />the City, until <br />accepted by the Superinh ndent of the Wotor <br />Department. <br />Sign1ed.:�.:..:.. .,..._ . .� ,..._ <br />..._.Applicant <br />Su Pvrinlendenl. <br />