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w. o te,m t <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett,....... <br />TO THE SUPERINTENDENT C <br />OF EVERE R DEPARTMENT': <br />lotions of theaWstar Depfor artment, foe of r purposes In and fixtulres th statedebelowregu- .l <br />During the time that any of the water molna may be taken up by reason <br />of any Iin mPhrovements authorized byhave beenI the City of Everett, in or of any street or <br />allewater during the ch p ogress of such improvemelrts lot any consbe umer whoseed to rnish <br />up- , <br />ply may thus be cut off, or be liable for any d:.mages for its failure so to do, j <br />Application No......,/-..";Z -_ <br />......... Add.._.cdrr.Es:.t.:""•�- <br />// /% ......street <br />.......................... _.... _ _ - <br />The work to be executed by. ........ ...-.--.... - - --- - .Plumber <br />Ste,�ylesize of lap. <br />..l.. /.....Tap to be Inserted in the main. <br />... Water closet <br />........ ..Bath <br />f? <br />...............Urinal <br />._...Plain faucet inside <br />F i <br />Side walk washer d <br />� O <br />_...... <br />...... Hose bib outside <br />.. Hose bib for building purposes <br />..... Hose bib Inside <br />.... Bib for stable containing .................... stall... _... <br />......... ......Number of persons In family <br />...........Number of rooms in building <br />The premises are to be used no a..... _.. .. <br />The owner of the premises Is....__...... <br />The agent Is ..... <br />This application, although signed, shall not be binding upon the Cite, until <br />accepted by the Superintendent of the Water Deportment. <br />�, �1 p ucani <br />Signed........J�.�:,�...t�.eru......a�....�..:-.. _-,.: ... Apf ' <br />Accepted. ..... By... ..... ._ .. <br />Superintendent. <br />