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� l/ <br />W.D. 1o1m 4 <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett .................. <br />......... I......... ...............19.� .y <br />TO THE SUPERINTENDENT <br />OF THE <br />EWATE R DEPARTMENT: <br />regu- <br />lations of theaWatyfor er Department, forer purposes and accordance <br />ix uiresthe statedebelow�egu- <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 <br />malt thus be cut oft, or be liable improvements <br />orvany d damages for itsufailu failure to do. <br />Application No .... ..... ..... ................ <br />//....... /I}ham <br />Block......................... .... Lot.... -._........._, /..... Add:............:¢i. 3 ! <br />f --, .J i� i s.� .`..:..Street <br />No...... ..............�..E!.,�.. •...-%...�... ._.. _..._.........._....... <br />.............. ............................. ..... ... ............ ..I......... <br />The work to be executed by <br />..... .I........... <br />Plumber <br />Slate size of tap. <br />- <br />....._...... ...Tap to be inserted In the main. <br />Water closet <br />LyL..........Both <br />i <br />f'y ! Llei <br />� % <br />................Urinal <br />................Plain faucet Inside ` <br />�, --1�� �•,_ <br />�% ,tiz�l <br />................Side walk washer <br />................Bose bib outside <br />q �, <br />i <br />_ ..............Bose bib for building purposes <br />................ Hose bib inside <br />i y <br />.....,.._...... Bib for stable containing... .......... <br />......stall........._(.:::,....; <br />Number of Persons In family <br />// <br />.....(n........ Number of rooms in building <br />The premises are to be used as a_ <br />.............................. <br />The owner of the Premises Is ... . .... ... <br />........_.... _. _,........ _.... . ._,.., .... <br />............. <br />The agent Is.... <br />This application, allhtlfigh si ed, shall oot be binding upon the City, until <br />accepted by the Superintendent of ihr WjH"er <br />Signed '� '- '..._off(..... <br />rD�epJ�rt //, <br />.. if .?,./Applicant <br />...........19.._... By....__ <br />Accepted.. _.....i f/- <br />............................ rt...I... _..._....._.... <br />Superintendent. <br />