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W. D. Form a <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />All blanks must be filled in or crossed out <br />Everett................ ............._........ �4r.:.. �.. <br />TO THE SUPERINTENDENT OF THE <br />EWATEER DEPARTMENT: <br />CITYlations of theaWalter Departfor the ment, for of er in purposes and accordancehe <br />the time that any, of the water mains may be taken up by reason <br />of any ImIn provements authorized byen 1 the City of Everett, 1n or of any street or <br />allewater during the. ich progress of have such improvements lot not be any consumer wed hosernish <br />up - <br />ply may thus be cut off, or be liable for any damages for Its failure Be to do. <br />Application No....J.... .......... <br />,�'.._...._..... Add... G.;.lr�...... <br />Block ..........�........_................Lot..... 7r�e, � <br />_. % tf.�............ street <br />.........._............................................................... <br />.. The work to be executed by.........__. _ <br />. <br />_... __....._......_........._.Plumber <br />State size of tap. <br />y ...Tap to be inserted In the main. <br />.Water closet <br />Bath <br />A <br />■ ' g^i I <br />`L. <br />............Urinal <br />Plain faucet inside <br />�e <br />................Side walk washer <br />................Hose bib outside <br />cayw tvtmaa : iL <br />..............Hose bib for building purposes <br />a aw- All <br />............... Hose bib Inside <br />,3(.c'( <br />f ................ Bib for stable containing..__ _..._._stall <br />................ <br />/ ..Number of persons in family <br />• ' %l <br />....(......Number of rooms In building <br />l�.cc <br />The premises are to be used as a_.... _...... <br />_. �+ <br />The owner of the premises is.... _. <br />�' ->� e�-ere. " <br />Theagent Is ............ ............. .._. <br />_..._...._._................................_......... <br />This application, ']thou h signed, shall not <br />be binding upon the City, until <br />accepted by the Superinlpplll of the Water <br />Department. <br />.&1,11.O......... <br />....................... ................_.....Applicant <br />Accepted ... By......... <br />._........ _.. _.. _... -. . <br />Superinlendcnl. <br />