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\V. A fnrn n <br />CITY OF EVERETT-WATER DEPARTMENT <br />APPLICATION FOR WATER <br />blanks must be filled in or crossed out <br />Everett ...... ..................... <br />`1.:.. �.....< `. _............ t!l. ..... <br />TO THE SUPERINTENDENT OF THE WATER DEPARTMENT: <br />CITY OF EVERETP: <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 />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 />E 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 No...�%�.f � .¢, .................... <br />1} Block ...... _... .._....................... Lot ............ �:..✓..................... Add ..... ....... ..................... ........ <br />......Street <br />r'....................................................................................................................................................... <br />The work to be executed b <br />,.._„•. Y... .............................. <br />................................. _. Plumber <br />State size of tap. <br />./..f�.'........ Top to be Inserted in the main. <br />l .....Water closet <br />'�d-�Q� <br />................Bath <br />/ <br />�Jo <br />�.. ................Urinal <br />)0 <br />��`%' ih <br />94 <br />Plain faucet Inside <br />................Side wal c washer <br />................Hose bib outside <br />................Bose bib for building purposes <br />................Hose bib inside <br />- ...............:dib for stable containing .................... <br />stall .............. _. <br />................Number of persons In family <br />L. ................Number of rooms in building <br />The premises are to be used as n._ .__...... <br />.. _..........._........... ............... <br />The owner of the premis,q is <br />\ The agent Is .................. <br />_... ... _... <br />This application, although signed, shall not be binding upon the City, until <br />by the Superintond t • <br />ccepled of the Wate�j <br />/ '/ <br />partment.� <br />l�'a <br />1 Signed....... _.�.L.L../../....k`j'..! <br />�.. . <br />�.f�r.....:................Applicant <br />pled.........................................1A....... By..... <br />Superintendent. i <br />